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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Hospital-acquired and ventilator-associated pneumonia caused by multidrug-resistant Gram-negative pathogens:
Dalal Hammoudi Halat1, Carole Ayoub Moubareck2
1Academic Quality Department, QU Health, Qatar University, Doha, Qatar.
Abstract:
The ongoing spread of antimicrobial resistance has complicated the treatment of bacterial hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). Gram-negative pathogens, especially those with multidrug-resistant profiles, including Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Pseudomonas aeruginosa, and Acinetobacter spp., are important culprits in this type of infections. Understanding the determinants of resistance in pathogens causing pneumonia is ultimately stressing, especially in the shadows of the COVID-19 pandemic, when bacterial lung infections are considered a top priority that has become urgent to revise. Globally, the increasing prevalence of these pathogens in respiratory samples represents a significant infection challenge, with major limitations of treatment options and poor clinical outcomes. This review will focus on the epidemiology of HAP and VAP and will present the roles and the antimicrobial resistance patterns of implicated multidrug-resistant (MDR) Gram-negative pathogens like carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Enterobacterales (CRE), as well as colistin-resistant Gram-negative pathogens and extended-spectrum β-lactamase (ESBL)-producing Enterobacterales. While emerging from the COVID-19 pandemic, perspectives and conclusions are drawn from findings of HAP and VAP caused by MDR Gram-negative bacteria in patients with COVID-19.
Insights
Antimicrobial resistance complicates hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) treatment. This review examines multidrug-resistant Gram-negative pathogens, crucial in HAP/VAP, especially post-COVID-19.
Area of Science:
- Infectious Diseases
- Microbiology
- Critical Care Medicine
Background:
- Antimicrobial resistance (AMR) poses a significant challenge in treating bacterial hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP).
- Multidrug-resistant (MDR) Gram-negative pathogens, including *Escherichia coli*, *Klebsiella pneumoniae*, *Enterobacter* spp., *Pseudomonas aeruginosa*, and *Acinetobacter* spp., are primary causative agents.
- The COVID-19 pandemic has heightened the urgency of understanding and combating these resistant bacterial lung infections.
Purpose of the Study:
- To review the epidemiology of HAP and VAP.
- To elucidate the roles and antimicrobial resistance patterns of key MDR Gram-negative pathogens implicated in these infections.
- To provide insights into HAP/VAP caused by MDR Gram-negative bacteria in the context of the COVID-19 pandemic.
Main Methods:
- Literature review focusing on epidemiology and antimicrobial resistance patterns.
- Analysis of data concerning MDR Gram-negative pathogens in HAP and VAP.
- Synthesis of findings related to carbapenem-resistant *Acinetobacter baumannii* (CRAB), carbapenem-resistant *Pseudomonas aeruginosa* (CRPA), carbapenem-resistant Enterobacterales (CRE), colistin-resistant Gram-negative pathogens, and extended-spectrum β-lactamase (ESBL)-producing Enterobacterales.
Main Results:
- MDR Gram-negative pathogens are prevalent in HAP and VAP, leading to limited treatment options and poor outcomes.
- Specific MDR pathogens like CRAB, CRPA, CRE, colistin-resistant strains, and ESBL-producers present significant therapeutic challenges.
- The review highlights the critical interplay between MDR Gram-negative infections and HAP/VAP in COVID-19 patients.
Conclusions:
- Understanding resistance determinants in HAP/VAP pathogens is crucial, particularly given the rise of MDR strains.
- Effective strategies are needed to combat the increasing prevalence and impact of MDR Gram-negative bacteria in pneumonia.
- Findings underscore the need for revised approaches to managing bacterial pneumonia in the post-pandemic era.
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