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Clinical problems posed by multiresistant nonfermenting gram-negative pathogens
1Department of Medicine, University of Illinois at Chicago, College of Medicine, USA.
Abstract:
In this review I will briefly survey the role of Pseudomonas aeruginosa, Acinetobacter baumanii, Stenotrophomonas maltophilia, and Burkholderia cepacia as opportunistic pathogens. A common feature of these organisms is intrinsic resistance to multiple antibiotics. All of these organisms can be recovered from the environment, commonly cause device-related infections, are often resistant to disinfectants, and have the potential to spread from patient to patient via fomites or the hands of medical personnel. Newer clinical syndromes will be emphasized, including the increasing importance of P. aeruginosa infections in patients with AIDS, as well as the role of carbapenems in selecting for A. baumanii and S. maltophilia and the unique niche of B. cepacia in patients with cystic fibrosis.
Insights
This review examines opportunistic pathogens Pseudomonas aeruginosa, Acinetobacter baumanii, Stenotrophomonas maltophilia, and Burkholderia cepacia. These bacteria exhibit intrinsic antibiotic resistance and pose significant healthcare challenges.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Opportunistic pathogens like Pseudomonas aeruginosa, Acinetobacter baumanii, Stenotrophomonas maltophilia, and Burkholderia cepacia are significant threats in healthcare settings.
- These bacteria are frequently isolated from the environment and are associated with device-related infections.
- Intrinsic resistance to multiple antibiotics and disinfectants, along with facile transmission via fomites and healthcare personnel, contribute to their clinical importance.
Purpose of the Study:
- To review the role of specific Gram-negative opportunistic pathogens.
- To highlight emerging clinical syndromes associated with these bacteria.
- To discuss the impact of antimicrobial resistance and specific therapeutic agents.
Main Methods:
- Literature review of Pseudomonas aeruginosa, Acinetobacter baumanii, Stenotrophomonas maltophilia, and Burkholderia cepacia.
- Emphasis on intrinsic antibiotic resistance mechanisms.
- Discussion of clinical syndromes and epidemiological factors.
Main Results:
- Pseudomonas aeruginosa, Acinetobacter baumanii, Stenotrophomonas maltophilia, and Burkholderia cepacia are significant opportunistic pathogens with intrinsic multidrug resistance.
- These organisms are linked to device-related infections and environmental persistence.
- Emerging issues include P. aeruginosa in AIDS patients, carbapenem-selected A. baumanii and S. maltophilia, and B. cepacia in cystic fibrosis.
Conclusions:
- These opportunistic pathogens represent a growing challenge due to intrinsic resistance and adaptability.
- Understanding their unique clinical niches and resistance patterns is crucial for effective management.
- Antimicrobial stewardship and infection control are vital to combat the spread of these multidrug-resistant organisms.