Addressing the Emergence and Impact of Multidrug-Resistant Gram-Negative Organisms: A Critical Focus for the Next Decade

July 30, 2014 at 2:32 pm

Infection Control & Hospital Epidemiology April 2014 V.35 N.4 P.333-335

Ebbing Lautenbach, MD, MPH, MSCE1 and Eli N. Perencevich, MD, MS2

  1. Division of Infectious Diseases, Department of Medicine, Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
  2. Division of General Internal Medicine, Department of Internal Medicine, Carver College of Medicine, University of Iowa, and Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Administration Health Care System, Iowa City, Iowa

Address correspondence to Ebbing Lautenbach, MD, MPH, MSCE, Center for Clinical Epidemiology and Biostatistics, 825 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021 (ebbing@mail.med.upenn.edu).

Approximately 10% of hospitalizations are complicated by a healthcare-associated infection, and up to 75% of these are due to organisms resistant to first-line antimicrobial therapy.

Furthermore, antimicrobial-resistant bacterial infections are associated with significant increases in morbidity and mortality and incur upward of $20 billion in annual healthcare costs.

Antimicrobial resistance has increased significantly in all spheres of patient care: acute care hospitals, long-term acute care hospitals, long-term care, and the community. Despite these sobering facts, we remain woefully unprepared to address both current and future resistant organisms.

Although antimicrobial resistance has been noted in nearly all bacterial pathogens, multidrug resistance among gram-negative bacteria represents a unique and immediate threat.

In the past decade, there has been a dramatic increase in the prevalence of various types of antimicrobial-resistant gram-negative bacteria, including extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, and multidrug-resistant strains of Pseudomonas aeruginosa and Acinetobacter baumannii.

Infections due to these organisms have been associated with significantly worse clinical outcomes, with mortality rates up to 4 times higher than infections caused by susceptible strains.

Furthermore, the potential for widespread and rapid transmission of these pathogens and/or the underlying genetic determinants of their resistance is of great concern….

abstract

http://www.jstor.org/stable/10.1086/675592

PDF 

http://www.jstor.org/stable/pdfplus/10.1086/675592.pdf?acceptTC=true&jpdConfirm=true

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Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Epidemiología, Infecciones emergentes, Metodos diagnosticos, Resistencia bacteriana, Sepsis.

INFLUENZA – EVOLUCIÓN A CUATRO AÑOS DE LA PANDEMIA Clinical Microbiology Costs for Methods of Active Surveillance for Klebsiella pneumoniae Carbapenemase–Producing Enterobacteriaceae


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