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[Multidrug-resistant gram-negative rods in the intensive care unit : Epidemiology, prevention and treatment options]

G Valenza1

  • 1Dienststelle Erlangen, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Eggenreuther Weg 43, 91058, Erlangen, Deutschland. giuseppe.valenza@lgl.bayern.de.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|March 3, 2019
PubMed

Insights

Multidrug-resistant gram-negative rods (MRGN) are increasing in German ICUs. Strategies include hygiene, isolation, and susceptibility-guided treatment for 3MRGN and 4MRGN infections.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Multidrug-resistant gram-negative rods (MRGN) are a growing concern in healthcare settings.
  • In Germany, MRGN are classified as 3MRGN (resistance to 3 antibiotic groups) or 4MRGN (resistance to 4 antibiotic groups).
  • Specific antibiotic groups include acylureidopenicillins, cephalosporins, fluoroquinolones, and carbapenemes.

Purpose of the Study:

  • To analyze the trends of 3MRGN and 4MRGN pathogens in German intensive care units (ICUs).
  • To understand the antimicrobial resistance mechanisms associated with MRGN phenotypes.
  • To outline current strategies for MRGN prevention, control, and treatment in ICUs.

Main Methods:

  • Retrospective analysis of MRGN data from German ICUs (2008-2014).
  • Classification of MRGN based on resistance profiles against key antibiotic classes.
  • Review of antimicrobial resistance mechanisms (e.g., ESBL, carbapenemases).

Main Results:

  • Significant increase in 3MRGN Enterobacteria and 4MRGN Pseudomonas aeruginosa rates in German ICUs from 2008-2014.
  • 4MRGN Enterobacteria remain rare.
  • Phenotypes linked to resistance mechanisms like ESBL and carbapenemases.

Conclusions:

  • Intensified surveillance and control measures are crucial for combating rising MRGN rates in ICUs.
  • Adherence to basic hygiene and special isolation precautions is essential.
  • Tailored antimicrobial therapy based on susceptibility testing is vital for effective MRGN infection management.
Keywords:
Beta-lactamasesCarbapenem-resistant enterobacteriaceaeEpidemiologyPreventive medicineTreatment

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