An overview of guidelines for the management of hospital-acquired and ventilator-associated pneumonia caused by multidrug-resistant Gram-negative bacteria

2019 ◽  
Vol 32 (6) ◽  
pp. 656-662 ◽  
Author(s):  
Catia Cillóniz ◽  
Cristina Dominedò ◽  
Antoni Torres
Keyword(s):  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Gram Negative ◽  
Hospital Acquired

scholarly journals Trends of 9,416 multidrug-resistant Gram-negative bacteria

2015 ◽  
Vol 61 (3) ◽  
pp. 244-249 ◽  
Author(s):  
Viviane Decicera Colombo Oliveira ◽  
Fernando Góngora Rubio ◽  
Margarete Teresa Gottardo Almeida ◽  
Mara Corrêa Lelles Nogueira ◽  
Antonio Carlos Campos Pignatari
Keyword(s):  
Gradual Increase ◽  
Carbapenem Resistance ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Clinical Specimens ◽  
Bacterial Sensitivity ◽  
Hospital Acquired ◽  
Multiple Antibiotics

Summary Objective: a resistance of hospital-acquired bacteria to multiple antibiotics is a major concern worldwide. The objective of this study was to investigate multidrugresistant (MDR) bacteria, clinical specimens, origin of specimen and trends, and correlate these with bacterial sensitivity and consumption of antimicrobials. Methods: 9,416 bacteria of nosocomial origin were evaluated in a tertiary hospital, from 1999 to 2008. MDR was defined for Gram-negative bacteria (GNB) as resistance to two or more classes/groups of antibiotics. Results: GNB MDR increased by 3.7 times over the study period (p<0.001). Acinetobacter baumannii was the most prevalent (36.2%). Over the study period, there were significant 4.8-fold and 14.6-fold increases for A. baumannii and K. pneumoniae (p<0.001), respectively. Sixty-seven percent of isolates of MDR GNB were isolated in intensive care units. The resistance of A. baumannii to carbapenems increased from 7.4 to 57.5% during the study period and concomitant with an increased consumption. Conclusion: that decade showed prevalence of GNB and a gradual increase in MDR GNB. There was an increase in carbapenem resistance of 50.1% during the study.

scholarly journals Cefiderocol, a new antibiotic against multidrug-resistant Gram-negative bacteria

2021 ◽  
Vol 34 (Suppl 1) ◽  
pp. 41-43
Author(s):  
José Tiago Silva ◽  
Francisco López-Medrano
Keyword(s):  
Bacterial Pneumonia ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Phase Iii ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Tract Infections ◽  
Transport Channels ◽  
Hospital Acquired

Cefiderocol is a novel catechol-substituted siderophore cephalosporin that binds to the extracellular free iron, and uses the bacterial active iron transport channels to penetrate in the periplasmic space of Gram-negative bacteria (GNB). Cefiderocol overcomes many resistance mechanisms of these bacteria. Cefiderocol is approved for the treatment of complicated urinary tract infections, hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia in the case of adults with limited treatment options, based on the clinical data from the APEKS-cUTI, APEKS-NP and CREDIBLE-CR trials. In the CREDIBLE-CR trial, a higher all-cause mortality was observed in the group of patients who received cefiderocol, especially those with severe infections due to Acinetobacter spp. Further phase III clinical studies are necessary in order to evaluate cefiderocol´s efficacy in the treatment of serious infections.

scholarly journals A Review of Superbug: A Global Threat in Health Care System

2018 ◽  
Vol 4 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Bhuiyan Mohammad Mahtab Uddin ◽  
Md Abdullah Yusuf ◽  
Zubair Ahmed Ratan
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Antimicrobial Agents ◽  
Public Health Problem ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Major Public Health Problem ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Hospital Acquired

The rapid spread and dissemination of the multidrug-resistant bacteria worldwide represents a major public health problem. The development of antibiotics decreased the mortality among the human and animals leading to a better life expectancy. But the injudicious use of antimicrobials and selection pressure the microbes have developed resistance which became more prominent during last few decades. With the evolution of Methicilin-resistant Staphylococcus aureus (MRSA), Hospital-acquired MRSA, Communityacquired MRSA and MDR TB (Multidrug resistant tuberculosis) challenge for the clinicians have increased to a greater extent. The global emergence and dissemination of acquired carbapenemases among gram negative bacteria are considered a major public health problem. Gram-negative bacteria, most notably Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii, are among the most important causes of serious hospital-acquired and community-onset bacterial infections in humans, and resistance to antimicrobial agents in these bacteria has become an increasingly relevant problem. Recent development in nanotechnology based drug delivery system may prove to be solution for combating these resistant bacteria. However policies and regulations for antibiotic use should be formulated to control the further development of resistance among the microbes.Bangladesh Journal of Infectious Diseases 2017;4(1):25-28

scholarly journals Equal Efficacy of Glucoprotamin and an Aldehyde Product for Environmental Disinfection in a Hematologic Transplant Unit: A Prospective Crossover Trial

2012 ◽  
Vol 33 (11) ◽  
pp. 1077-1080 ◽  
Author(s):  
Ruth Meinke ◽  
Bernhard Meyer ◽  
Reno Frei ◽  
Jakob Passweg ◽  
Andreas F. Widmer
Keyword(s):  
Similar Efficacy ◽  
Multidrug Resistant ◽  
Hospital Environment ◽  
Gram Negative Bacteria ◽  
Current Standard ◽  
Gram Negative ◽  
Selective Media ◽  
Significant Difference ◽  
Hospital Acquired ◽  
Environmental Disinfection

Background.The inanimate hospital environment has emerged as an important reservoir of nosocomial pathogens. In particular, multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus, Acinetobacter species, and Clostridium difficile, play a major role in the transmission of hospital-acquired infections. In Europe, aldehydes, chlorine, and quaternary ammonium compounds have been commonly used for environmental disinfection. Glucoprotamin, a newer active compound for disinfectants, has been clinically tested for disinfection of instruments but not for environmental disinfection.Objective.This study evaluated the antimicrobial effectiveness of a glucoprotamin-containing product (Incidin) compared with that of an aldehyde-containing product (Deconex), the current standard at our institution.Methods.This prospective crossover study was conducted in our access-restricted hematologic transplant unit. A total of 3,086 samples from the environment were processed and examined for overall bacterial burden as well as selectively for S. aureus, C. difficile, and gram-negative bacteria.Results.There was no significant difference in residual bacteria after disinfection between the 2 products in terms of overall burden and selected pathogens. Enterococci were the predominant pathogens recovered from surfaces, but no vancomycin-resistant enterococci were recovered. Similarly, C. difficile could not be found in the patients' environment, even in rooms, despite the use of selective media.Conclusion.The aldehyde-containing product (Deconex) and the glucoprotamin-containing product (Incidin) demonstrated similar efficacy against environmental contamination in a hematologic transplant unit with the application of selective media for C. difficile, S. aureus, and gram-negative bacteria in addition to standard medium.

scholarly journals The Potential Role of Aerosolized Colistin in the Ventilator-Associated Pneumonia Management Caused by Multidrug-Resistant Gram-Negative Bacteria: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Faezeh Feizabadi ◽  
Seyed Mohammad Reza Hashemian ◽  
Zahra Mirshafiei ◽  
Farzaneh Dastan
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Multidrug Resistant ◽  
Sputum Culture ◽  
Control Group ◽  
Gram Negative Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Gram Negative ◽  
Days Of Therapy ◽  
Negative Sputum

Background: Infections caused by multidrug-resistant (MDR) pathogen have caused a resurgence of interest in colistin. To date, information about the effectiveness of Aerosolized Colistin (AS) is very limited in the treatment of Ventilator-Associated Pneumonia (VAP). The aim of this study is to evaluate the efficacy and safety of AS in conjunction with intravenous (IV) colistin in patients with VAP, caused by MDR Gram-Negative Bacteria (GNB). Methods: This parallel randomized clinical trial was conducted on patients with VAP in the Intensive Care Unit (ICU) ward. 27 patients allocated to the intervention or the control group. Patients in the intervention group received IV Colistin based on glomerular filtration rate along with aerosolized Colistin, 2 million units three times a day. In the control group, only IV Colistin was administered. For all patients, Procalcitonin (PCT), sputum culture, and Clinical Pulmonary Infection Score (CPIS) were evaluated and compared as outcome measures at the specified period of time. Results: Negative sputum culture was achieved in 9 (80%) out of 11 patients in the AS-IV Colistin group after seven days of therapy versus 9 (56.25%) out of 16 in the control group (P= 0.01). PCT and CPIS scores were not significantly different between two groups (P=0.21, P= 0.62). Furthermore, nephrotoxicity and neurotoxicity were not seen. Conclusion: AS Colistin lead to earlier negative sputum culture without increasing risk of nephrotoxicity and neurotoxicity, and could potentially be a beneficial adjunctive approach in the management of MDR-VAP.

scholarly journals Aerosolized colistin as adjunctive treatment of ventilator-associated pneumonia due to multidrug-resistant Gram-negative bacteria: A prospective study

2008 ◽  
Vol 102 (3) ◽  
pp. 407-412 ◽  
Author(s):  
Argyris Michalopoulos ◽  
Dimitrios Fotakis ◽  
Simona Virtzili ◽  
Christodoulos Vletsas ◽  
Sylvia Raftopoulou ◽  
...  
Keyword(s):  
Prospective Study ◽  
Multidrug Resistant ◽  
Adjunctive Treatment ◽  
Gram Negative Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Gram Negative ◽  
A Prospective Study
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