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[Resistant gram-negative bacteria. Therapeutic approach and risk factors]
Abstract:
The rapid spread of multidrug-resistant bacteria has become a serious threat, especially in critical care units, thereby prolonging the hospital stay. Enterobacteriaceae have a high capacity to adapt to any environment. Plasmids are the reason behind their expansion. The choice of empiric therapy for intra-abdominal or urinary infections requires knowledge of the intrinsic microbiological variability of each hospital or critical care unit, as well as the source of infection, safety or antibiotic toxicity, interaction with other drugs, the dosage regimen and the presence of risk factors. Carbapenems are the drug of choice in the case of suspected infection by ESBL-producing Enterobacteriaceae. The new ceftazidime/avibactam and ceftolozane/tazobactam drugs are opening up promising new horizons in the treatment of multidrug-resistant Enterobacteriaceae.
Insights
Multidrug-resistant bacteria, particularly Enterobacteriaceae, pose a significant threat in critical care. New antibiotics like ceftazidime/avibactam offer promising treatments for these resistant infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Multidrug-resistant bacteria, especially Enterobacteriaceae, are a growing global health concern, leading to prolonged hospital stays.
- Plasmids facilitate the rapid spread and adaptability of Enterobacteriaceae.
- Effective empiric therapy for intra-abdominal and urinary infections necessitates understanding hospital-specific microbial variations and patient factors.
Purpose of the Study:
- To review the challenges posed by multidrug-resistant Enterobacteriaceae in critical care settings.
- To discuss current treatment strategies, including the role of carbapenems.
- To highlight emerging therapeutic options for infections caused by these resistant pathogens.
Main Methods:
- Literature review of studies on multidrug-resistant Enterobacteriaceae.
- Analysis of treatment guidelines for intra-abdominal and urinary tract infections.
- Evaluation of the efficacy and potential of novel antibiotic agents.
Main Results:
- Carbapenems remain a primary choice for suspected infections with ESBL-producing Enterobacteriaceae.
- Emerging resistance necessitates continuous monitoring of local antibiograms.
- Ceftazidime/avibactam and ceftolozane/tazobactam demonstrate significant potential against multidrug-resistant strains.
Conclusions:
- The rise of multidrug-resistant Enterobacteriaceae requires vigilant surveillance and strategic treatment approaches.
- Novel antibiotics like ceftazidime/avibactam and ceftolozane/tazobactam represent crucial advancements in combating these challenging infections.
- Personalized therapy, considering infection source and patient risk factors, is essential for optimal outcomes.
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