Antimicrobial Resistance: Highlights of New Antibiotics for Gram-negative Organisms

2016 ◽  
Vol 12 (5) ◽  
pp. 354-355 ◽  
Author(s):  
Kanika Ballani ◽  
Jason Babby
Keyword(s):  
Antimicrobial Resistance ◽  
Gram Negative ◽  
New Antibiotics ◽  
Gram Negative Organisms

Antimicrobial Resistance in the Intensive Care Unit

2016 ◽  
Vol 32 (1) ◽  
pp. 25-37 ◽  
Author(s):  
Shawn H. MacVane
Keyword(s):  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Treatment Options ◽  
Hospital Costs ◽  
High Morbidity ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Gram Negative Organisms

Bacterial infections are a frequent cause of hospitalization, and nosocomial infections are an increasingly common condition, particularly within the acute/critical care setting. Infection control practices and new antimicrobial development have primarily focused on gram-positive bacteria; however, in recent years, the incidence of infections caused by gram-negative bacteria has risen considerably in intensive care units. Infections caused by multidrug-resistant (MDR) gram-negative organisms are associated with high morbidity and mortality, with significant direct and indirect costs resulting from prolonged hospitalizations due to antibiotic treatment failures. Of particular concern is the increasing prevalence of antimicrobial resistance to β-lactam antibiotics (including carbapenems) among Pseudomonas aeruginosa and Acinetobacter baumannii and, recently, among pathogens of the Enterobacteriaceae family. Treatment options for infections caused by these pathogens are limited. Antimicrobial stewardship programs focus on optimizing the appropriate use of currently available antimicrobial agents with the goals of improving outcomes for patients with infections caused by MDR gram-negative organisms, slowing the progression of antimicrobial resistance, and reducing hospital costs. Newly approved treatment options are available, such as β-lactam/β-lactamase inhibitor combinations, which significantly extend the armamentarium against MDR gram-negative bacteria.

scholarly journals Microbial Contamination and Antimicrobial Resistance in Use of Ophthalmic Solutions at the Department of Ophthalmology, Jimma University Specialized Hospital, Southwest Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Lemlem Tamrat ◽  
Yeshigeta Gelaw ◽  
Getenet Beyene ◽  
Addisu Gize
Keyword(s):  
Antimicrobial Resistance ◽  
Eye Drops ◽  
Southwest Ethiopia ◽  
Gram Negative ◽  
Microbial Identification ◽  
Specialized Hospital ◽  
Department Of Ophthalmology ◽  
Gram Negative Organisms ◽  
Ophthalmic Solutions ◽  
Jimma University

Background. Eye drops are most frequently used medications in ophthalmology. The carriage of pathogenic organisms to eyes through the agency of eye drops has presented a serious problem for several decades. The objective of this study was to determine the magnitude of contamination and pattern of antimicrobial resistance of in-use ophthalmic solutions. Method. A cross-sectional study was conducted at the Department of Ophthalmology, Jimma University Specialized Hospital (JUSH), Southwest Ethiopia, from June to December 2015. Samples from all ophthalmic solutions from outpatient department, operation theaters, and wards after an average duration of use of two weeks were taken. Samples were cultured and organisms were identified; antimicrobial susceptibility testing was performed using standard microbial identification techniques. The data were analyzed using SPSS software. Chi-square test was done and associations were taken as significant if P<0.05. Result. The rate of contamination of eye drops in the study setup was found to be 51/70 (72.8%). Frequency of contamination of eye drops found was to be statistically associated with the duration of use of eye drops. Contaminations of eye drops were high among patients who self-administer the medications and those individuals who apply the medication less frequently. Tips of the bottles were more often contaminated than the content of the eye drop. Majority of both Gram-positive and Gram-negative organisms were sensitive for most of the broad-spectrum antibiotics; however, there were a significant number of Gram-negative organisms resistant to almost all antibiotics used. Conclusion. There is high rate of contamination of eye drops in the setup (72.8%). Duration of use of eye drops is a significant factor associated with contamination. Knowing duration time of each container and patient education on eye drop administration technique are mandatory.

scholarly journals Canadian Patterns of Antimicrobial Resistance: Overview of Current Trends Related to Hospital Pathogens

2006 ◽  
Vol 17 (suppl b) ◽  
pp. 3B-5B
Author(s):  
Tony Mazzulli
Keyword(s):  
Antimicrobial Resistance ◽  
Methicillin Resistance ◽  
Geographical Location ◽  
Current Data ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Gram Negative ◽  
Canadian Data ◽  
Gram Negative Organisms ◽  
Resistance Rates

Selection of appropriate empirical antibiotic therapy is dependent on many factors, not the least of which is an understanding of antimicrobial resistance rates in the patient population that is undergoing treatment. Resistance rates may vary by geographical location, institution, hospital ward or unit, and even body site of infection. The present paper reviews the currently available Canadian data regarding resistance rates for some of the most common hospital-acquired pathogens, includingEscherichia coli,Klebsiellaspecies,Pseudomonas aeruginosa,Enterobacterspecies,Staphylococcus aureusandEnterococcusspecies. Current data suggest that the rates of extended-spectrum beta-lactamases amongE coliandKlebsiellaspecies remain relatively low across Canada. There are very little data on the epidemiology of ampC cephalosporinases among Gram-negative organisms, although combined American and Canadian data suggest that ceftazidime resistance rates forEnterobacterspecies range from 17.1% to 24.8%. The increased use of fluoroquinolones has led to an increase in resistance rates among most Gram-negative organisms. In the late 1990s, ciprofloxacin resistance rates forP aeruginosawere reported to be approximately 20%. For the Gram-positive organisms, methicillin resistance rates forS aureushave been reported to be as high as 10% and vancomycin resistance rates forEnterococcusspecies have been reported to be less than 1%. Additional data that are representative of all regions of Canada are needed. Continued surveillance, antibiotic stewardship, and adherence to good infection prevention and control measures will lead to a better understanding of the epidemiology of antimicrobial resistance in Canadian hospitals, as well as help to control its spread.

Intrinsic, adaptive and acquired antimicrobial resistance in Gram-negative bacteria

2017 ◽  
Vol 61 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Mohsen Arzanlou ◽  
Wern Chern Chai ◽  
Henrietta Venter
Keyword(s):  
Antimicrobial Resistance ◽  
Molecular Mechanisms ◽  
Resistance Mechanisms ◽  
Stress Conditions ◽  
Gram Negative Bacteria ◽  
Mechanisms Of Resistance ◽  
Intrinsic Resistance ◽  
Antimicrobial Drugs ◽  
Gram Negative ◽  
Gram Negative Organisms

Gram-negative bacteria are responsible for a large proportion of antimicrobial-resistant infections in humans and animals. Among this class of bacteria are also some of the most successful environmental organisms. Part of this success is their adaptability to a variety of different niches, their intrinsic resistance to antimicrobial drugs and their ability to rapidly acquire resistance mechanisms. These mechanisms of resistance are not exclusive and the interplay of several mechanisms causes high levels of resistance. In this review, we explore the molecular mechanisms underlying resistance in Gram-negative organisms and how these different mechanisms enable them to survive many different stress conditions.

scholarly journals Towards a better understanding of antimicrobial resistance dissemination: what can be learnt from studying model conjugative plasmids?

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Zhen Shen ◽  
Christoph M. Tang ◽  
Guang-Yu Liu
Keyword(s):  
Antimicrobial Resistance ◽  
Rational Design ◽  
Global Public Health ◽  
Human Pathogens ◽  
Bacterial Populations ◽  
Gram Negative ◽  
Conjugative Plasmids ◽  
Defense Systems ◽  
Metabolic Properties ◽  
Gram Negative Organisms

AbstractBacteria can evolve rapidly by acquiring new traits such as virulence, metabolic properties, and most importantly, antimicrobial resistance, through horizontal gene transfer (HGT). Multidrug resistance in bacteria, especially in Gram-negative organisms, has become a global public health threat often through the spread of mobile genetic elements. Conjugation represents a major form of HGT and involves the transfer of DNA from a donor bacterium to a recipient by direct contact. Conjugative plasmids, a major vehicle for the dissemination of antimicrobial resistance, are selfish elements capable of mediating their own transmission through conjugation. To spread to and survive in a new bacterial host, conjugative plasmids have evolved mechanisms to circumvent both host defense systems and compete with co-resident plasmids. Such mechanisms have mostly been studied in model plasmids such as the F plasmid, rather than in conjugative plasmids that confer antimicrobial resistance (AMR) in important human pathogens. A better understanding of these mechanisms is crucial for predicting the flow of antimicrobial resistance-conferring conjugative plasmids among bacterial populations and guiding the rational design of strategies to halt the spread of antimicrobial resistance. Here, we review mechanisms employed by conjugative plasmids that promote their transmission and establishment in Gram-negative bacteria, by following the life cycle of conjugative plasmids.

Infections due to Escherichia coli and Other Enteric Gram-Negative Bacilli

2016 ◽  
Author(s):  
Allison Mah ◽  
Inna Sekirov ◽  
Theodore S Steiner
Keyword(s):  
Escherichia Coli ◽  
Gastrointestinal Tract ◽  
Antimicrobial Resistance ◽  
Clinical Manifestations ◽  
Gram Negative ◽  
The Family ◽  
Enteric Infections ◽  
Gram Negative Organisms ◽  
Tract Infections

This review describes infections caused by Escherichia coli and related members of the family Enterobacteriaceae, excluding other genera that principally cause enteric infections. Infections caused by Salmonella, Shigella, and Yersinia are described in the review “Gastrointestinal Tract Infections," found elsewhere in this publication. The purpose of this review is to examine the specific epidemiology, clinical manifestations, and treatment of individual members of the Enterobacteriaceae. The emerging concern of antimicrobial resistance amongst enteric gram-negative organisms and the approach to treatment in the setting of infection with these resistant organisms are discussed in the review “Antimicrobial Resistance in Enteric Gram-Negative Organisms,” found elsewhere in this publication. Figures illustrate the mechanisms of antimicrobial resistance in Enterobacteriaceae. A table lists the clinical, epidemiologic, pathogenetic, and therapeutic aspects of infection with various pathotypes of Escherichia coli. This review contains 6 highly rendered figures, 1 table, and 79 references.

scholarly journals Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart Institute

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Lameck Ssemogerere ◽  
Cornelius Sendagire ◽  
Ceaser Mbabazi ◽  
Yvonne Namungoma ◽  
Anna Noland Oketayot ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Healthcare Workers ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Gram Negative ◽  
Heart Institute ◽  
Cardiac Intensive Care ◽  
Gram Negative Organisms

Background. Hands of healthcare workers (HCWs) are vehicles for pathogens responsible for healthcare-associated infections (HAIs). Following the identification of Gram-negative organisms (GNOs) in all cases of HAIs in the cardiac intensive care unit (ICU), we sought to determine the burden of hand colonization with GNOs among healthcare workers who access the cardiac ICU. Methods. We retrospectively reviewed results from surveillance cultures of fingertip imprints of HCWs who access the cardiac ICU at the Uganda Heart Institute. We collected data on staff category, isolates, and susceptibility to antibiotics. We analyzed the data using Microsoft Excel, and the results are summarized in proportions and percentages and presented in charts and tables. Results. Fifty-six healthcare workers participated in the surveillance. 21 were ICU clinicians, 21 non-ICU clinicians, and 14 nonclinicians. GNOs were cultured in 19 (33.9%) HCWs, in which 8/19 (42.1%) were non-ICU clinicians, 6/19 (31.2%) ICU clinicians, and 5/19 (26.3%) nonclinicians. 32 isolates were identified, of which 47%, 28%, and 25% were cultured from non-ICU clinicians, nonclinicians, and ICU clinicians, respectively. Predominant isolates were Acinetobacter (34%), Citrobacter (21.9%), and Pseudomonas (21.9%). Antimicrobial resistance ranged from 4% to 90%. 9/28 (32.1%) isolates, predominantly Acinetobacter species (spp), were carbapenem resistant. 8/28 (28.6%) isolates, predominantly Citrobacter spp, were multidrug resistant. Resistance to ciprofloxacin and cefepime was low at 3.6% and 4.4%, respectively. Conclusion. Gram-negative organisms, predominantly Acinetobacter, Citrobacter, and Pseudomonas spp, were prevalent on the hands of HCWs who access the cardiac ICU irrespective of the staff category. Antimicrobial resistance was high, with multidrug resistance and carbapenem resistance common among Citrobacter spp and Acinetobacter spp, respectively. Resistance to cefepime and ciprofloxacin was low.

Antimicrobial Resistance in Enteric Gram-Negative Organisms

2016 ◽  
Author(s):  
Allison Mah ◽  
Inna Sekirov ◽  
Theodore S Steiner
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Resistance Mechanisms ◽  
Current Treatment ◽  
Health Care Use ◽  
Gram Negative ◽  
Gram Negative Organisms ◽  
The Many

Antimicrobial resistance is a phenomenon that predates the introduction of antibiotics into clinical practice and has become an exponentially growing problem worldwide, leading to increased mortality and increased costs of health care use. Among the many organisms with ever-worsening resistance profiles, Escherichia coli and other Enterobacteriaceae species are significant pathogens, both in terms of numbers and the severity of the infections they cause. The purpose of this review is to examine the emerging concern of antimicrobial resistance and the approach to treatment in the setting of infection with resistant organisms. We will focus on the resistance mechanisms of Enterobacteriaceae to select antimicrobial classes, briefly discuss the epidemiology of resistance, and discuss current treatment strategies. The specific epidemiology, clinical manifestations, and treatment of individual members of the Enterobacteriaceae are discussed in the review “Infections Due to Escherichia coli and Other Enteric Gram-Negative Bacilli,” found elsewhere in this publication. Figures illustrate the mechanisms of antimicrobial resitance in Enterobacteriaceae. Tables list the Ambler classification of ESBL/AmpC and carbapenemase enzymes, and antibiotics with activity against carbapenem-resistant enterobacteriaceae. This review contains 4 highly rendered figures, 2 tables, and 27 references.

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