Antimicrobial resistance in nephrology
Tina Z Wang1, Rosy Priya L Kodiyanplakkal2, David P Calfee3,4
1NewYork Presbyterian-Weill Cornell Medical Center, New York, NY, USA.
Abstract:
The prevalence of antimicrobial resistance among many common bacterial pathogens is increasing. The emergence and global dissemination of these antibiotic-resistant bacteria (ARB) is fuelled by antibiotic selection pressure, inter-organism transmission of resistance determinants, suboptimal infection prevention practices and increasing ease and frequency of international travel, among other factors. Patients with chronic kidney disease, particularly those with end-stage renal disease who require dialysis and/or kidney transplantation, have some of the highest rates of colonization and infection with ARB worldwide. These ARB include methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus spp. and several multidrug-resistant Gram-negative organisms. Antimicrobial resistance limits treatment options and increases the risk of infection-related morbidity and mortality. Several new antibiotic agents with activity against some of the most common ARB have been developed, but resistance to these agents is already emerging and highlights the dire need for new treatment options as well as consistent implementation and improvement of basic infection prevention practices. Clinicians involved in the care of patients with renal disease must be familiar with the local epidemiology of ARB, remain vigilant for the emergence of novel resistance patterns and adhere strictly to practices proven to prevent transmission of ARB and other pathogens.
Insights
Antimicrobial resistance (AMR) is rising in bacterial pathogens, especially in patients with chronic kidney disease. New antibiotics are needed, alongside improved infection prevention, to combat this growing threat.
Area of Science:
- Infectious Diseases
- Nephrology
- Microbiology
Background:
- Antimicrobial resistance (AMR) is a growing global health concern, driven by factors including antibiotic use and international travel.
- Patients with chronic kidney disease (CKD), particularly those on dialysis or post-transplant, exhibit high rates of colonization and infection with antibiotic-resistant bacteria (ARB).
- Common ARB in CKD patients include methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and multidrug-resistant Gram-negative organisms.
Purpose of the Study:
- To highlight the increasing prevalence of AMR in bacterial pathogens.
- To emphasize the vulnerability of patients with chronic kidney disease to ARB infections.
- To underscore the urgent need for novel therapeutic strategies and enhanced infection control measures.
Main Methods:
- This abstract synthesizes current knowledge on antimicrobial resistance trends and their impact on patients with renal disease.
- It reviews the types of antibiotic-resistant bacteria commonly found in this patient population.
- It discusses the challenges posed by emerging resistance to new antibiotic agents.
Main Results:
- Antimicrobial resistance is increasing among common bacterial pathogens.
- Patients with chronic kidney disease are disproportionately affected by antibiotic-resistant bacteria.
- Emerging resistance to new antibiotics necessitates continuous development of novel treatments.
Conclusions:
- Effective management of ARB in renal disease patients requires vigilance for local resistance patterns and adherence to infection prevention practices.
- There is a critical need for new antimicrobial agents and improved infection control strategies.
- Clinicians must stay informed about evolving resistance and implement robust prevention measures to mitigate morbidity and mortality.
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