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Perceived differences between intensivists and infectious diseases consultants facing antimicrobial resistance: a

Jordi Rello1,2, Vandana Kalwaje Eshwara3, Andrew Conway-Morris4

  • 1CIBER de Enfermedades Respiratorias, CIBERES, Barcelona, Spain. jrello@crips.es.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|March 23, 2019
PubMed

Insights

Intensivists and infectious disease experts differ on managing multi-drug-resistant organisms in ICUs. Carbapenem resistance is a top concern for both, but priorities for control and education vary, highlighting the need for collaboration.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Multi-drug-resistant (MDR) organisms pose a significant threat in intensive care units (ICUs).
  • Understanding expert perceptions on MDR organisms and their management is crucial for effective control strategies.

Purpose of the Study:

  • To identify and compare the perceptions of intensive care unit (ICU) physicians and infectious disease (ID) consultants regarding MDR organisms and their management.
  • To highlight differences in pathogen priorities, treatment challenges, and infection control strategies between these expert groups.

Main Methods:

  • A cross-sectional survey was conducted among 129 global experts in infections in critically ill patients.
  • Respondents included ICU physicians (ICU/anesthesiology) and ID physicians/microbiologists.
  • Survey data were analyzed to identify differences in opinions on MDR organisms, management, and control.

Main Results:

  • Globally, ESBL Enterobacteriaceae, carbapenem-resistant *Acinetobacter baumannii*, and carbapenem-resistant *Klebsiella pneumoniae* were major concerns.
  • Significant differences were observed between ICU physicians and ID consultants regarding pathogen priorities and challenges in initial therapy selection.
  • Priorities for urgent measures to limit antibiotic resistance and prevent MDR spread also differed between the two groups, with carbapenem resistance being a universal concern.

Conclusions:

  • Perceptions and priorities regarding MDR organisms, infection control, and education vary between ICU physicians and ID/clinical microbiologists.
  • Addressing these differences through multi-disciplinary collaboration is essential for optimizing the care of critically ill patients with severe infections.
  • Carbapenem resistance is recognized as the most pressing emerging resistance concern by both specialties.
Keywords:
AntimicrobialsColonizationInfection controlIntensive careMultidrug-resistant bacteriaPreventionSepsis

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