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Related Concept Videos

Mechanism of Antibiotic Resistance in MRSA01:25

Mechanism of Antibiotic Resistance in MRSA

Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
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Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic

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Related Experiment Video

Updated: Jun 7, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Time-Dependent Association Between Invasive Procedures, Carbapenem Exposure, and Multidrug-Resistant Bloodstream

Shaoman Lin1, Xiaorui Lin2, Weitao Lv1

  • 1Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China.

Microbial Drug Resistance (Larchmont, N.Y.)
|June 5, 2026
PubMed
Summary

Critically ill patients face higher multidrug-resistant organism (MDRO) bloodstream infection (BSI) risks when carbapenem antibiotics are given soon after invasive procedures. This risk is highest within 48 hours post-procedure, influenced by nutritional and inflammatory factors.

Keywords:
ICUbloodstream infectionbroad-spectrum antibioticsinvasive proceduresmultidrug-resistant organismtemporal risk

Related Experiment Videos

Last Updated: Jun 7, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Critically ill patients often receive invasive procedures and broad-spectrum antibiotics, increasing multidrug-resistant organism (MDRO) bloodstream infection (BSI) risk.
  • The temporal relationship between early postprocedural exposures and MDRO BSI development is not fully understood.

Purpose of the Study:

  • To evaluate the association between invasive procedures, carbapenem exposure, and their overlap with MDRO BSI risk in critically ill patients.
  • To examine the temporal dynamics of these exposures in the early postprocedural period.
  • To explore the mediating roles of hypoalbuminemia and elevated C-reactive protein (CRP) in this association.

Main Methods:

  • Retrospective cohort study of 380 adult ICU admissions (2020-2023).
  • Propensity score matching (1:1) to balance patient characteristics.
  • Time-dependent Cox proportional hazards models to assess exposure associations with MDRO BSI.
  • Exploratory mediation analyses for hypoalbuminemia and CRP.

Main Results:

  • Overlapping exposure to invasive procedures and carbapenems significantly increased MDRO BSI risk (aHR: 4.0).
  • The risk was highest within 12 hours post-procedure (aHR: 5.1) and remained elevated through 48 hours (aHR: 3.3).
  • Hypoalbuminemia and elevated CRP partially mediated the association, accounting for ~32% and ~21% respectively.
  • Overlapping exposures correlated with lower 28-day infection-free survival.

Conclusions:

  • Carbapenem exposure shortly after invasive procedures in critically ill patients is temporally linked to increased MDRO BSI risk, especially within 48 hours.
  • Host nutritional status (hypoalbuminemia) and inflammation (elevated CRP) may contribute to this increased susceptibility.
  • Timing of antibiotic administration and patient vulnerability are crucial considerations for early broad-spectrum antibiotic use in ICUs.