Journal ArticleDOI
Patient specific risk stratification for antimicrobial resistance and possible treatment strategies in gram-negative bacterial infections
TLDR
This article covers MDRGN epidemiology, with a specific focus on risk factors for harbouring infections sustained by extended-spectrum-Beta-lactamase (ESBL), carbapenem resistant Enterobacteriacae (CRE), MDR Pseudomonas aeruginosa and MDR Acinetobacter baumanii, and proposes an algorithm for the choice of empiric treatment when a MDR GN infection is suspected.Abstract:
Introduction: The isolation of multi-drug-resistant gram-negative (MDRGN) pathogens has progressively increased worldwide and has been associated with important delays in the prescription of an adequate antibiotic treatment, resulting in increased mortality rates. Patient’s stratification for MDRGN infections to optimize the prescription of an adequate empiric antimicrobial regimen is crucial.Areas covered: This article covers MDRGN epidemiology, with a specific focus on risk factors for harbouring infections sustained by extended-spectrum-Beta-lactamase (ESBL), carbapenem resistant Enterobacteriacae (CRE), MDR Pseudomonas aeruginosa and MDR Acinetobacter baumanii. Moreover, we will propose an algorithm for the choice of empiric treatment when a MDRGN infection is suspected.Expert commentary: Although in clinical practice, a patient’s stratification represents a challenge, whenever a MDRGN pathogen is suspected broad-spectrum, combination empiric treatment should be promptly started, looking for a...read more
Citations
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Journal ArticleDOI
International prospective study of klebsiella pneumoniae bacteremia: Implications of extended-spectrum β-lactamase production in nosocomial infections
Journal ArticleDOI
Antimicrobial resistance in the next 30 years, humankind, bugs and drugs: a visionary approach.
Matteo Bassetti,Garyphallia Poulakou,Etienne Ruppé,Emilio Bouza,Sebastian Van Hal,Adrian Brink,Adrian Brink +6 more
TL;DR: The current standards of care and major recent advances with regard to antimicrobial resistance (AMR) are described and a prospective overview for the next 30 years in this field is given.
Journal ArticleDOI
Antimicrobial resistance and antibiotic stewardship programs in the ICU: insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR round table on multi-drug resistance
Jan De Waele,Murat Akova,Massimo Antonelli,Rafael Cantón,Jean Carlet,Daniel De Backer,George Dimopoulos,José Garnacho-Montero,Jozef Kesecioglu,Jeffrey Lipman,Jeffrey Lipman,Mervyn Mer,Josél Artur Paiva,Mario Poljak,Jason A. Roberts,Jesus Rodriguez Bano,Jean-François Timsit,Jean-François Timsit,Jean-Ralph Zahar,Matteo Bassetti +19 more
TL;DR: Intensive care and infectious disease specialists united in the ANTARCTICA (Antimicrobial Resistance in Critical Care) coalition, call for increased awareness and action among health care professionals to reduce AMR development in critically ill patients, to improve treatment of AMR infections and to coordinate scientific research in this high-risk patient population.
Journal ArticleDOI
Epidemiology of carbapenem-resistant Gram-negative infections globally
TL;DR: High-resistance rates in carbapenem-resistant GNB in many countries will inevitably complicate treatment of serious infections in vulnerable patient groups and should accelerate global attempts to overcome the impediments with regard to effective antimicrobial stewardship and infection prevention and control programs.
References
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Initiation of Inappropriate Antimicrobial Therapy Results in a Fivefold Reduction of Survival in Human Septic Shock
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TL;DR: Efforts to increase the frequency of the appropriateness of initial antimicrobial therapy must be central to efforts to reduce the mortality of patients with septic shock.
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