Antibiotic exposure and resistance development in Pseudomonas aeruginosa and Enterobacter species in intensive care units*

Abstract

Meropenem exposure is associated with the highest risk of resistance development in P. aeruginosa. Increasing carbapenem use attributable to emergence of Gram-negative bacteria producing extended-spectrum β-lactamases will enhance antibiotic resistance in P. aeruginosa.

Risk factors for carbapenem-resistant Gram-negative bacteremia in intensive care unit patients

“…However, after controlling for confounding factors and interaction, prior prolonged exposure to carbapenems was the only independent risk factor for ICU acquired CR-GNB. Carbapenems have been identified as a risk factor for CR Gram-negative isolates in previous studies [27][28][29][30]: carbapenem use was independently associated with imipenem-resistance [27]; imipenem exposure was the major risk factor for imipenem-resistant P. aeruginosa [21,28], and also for CR K. pneumoniae isolation [29]. However, there are exceptions to these findings: fluoroquinolones and antipseudomonal penicillins (and not carbapenems) were independent risk factors for CR K. pneumoniae infection elsewhere [31].…”

Emergence of antimicrobial resistance to Pseudomonas aeruginosa in the intensive care unit: association with the duration of antibiotic exposure and mode of administration

“…Several studies have explored the risk factors for P. aeruginosa antimicrobial resistance in non-critically ill patients [5, 6]. These studies showed that among antipseudomonas antibiotics, meropenem was associated with the highest risk of resistance emergence [4, 7]. The risk factors for emerging antimicrobial-resistant Pseudomonas aeruginosa in the ICU are also worth investigating, especially to answer the question how quick the antibiotic resistance emerges after the exposure to antibiotics.…”

Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

“…In einer kleineren Studie von 4 Intensivstationen in Deutschland erkrankten 25 % der mit ESBL-positiven Erregern besiedelten Patienten an einer Infektion (Harnwegs-und Wundinfektionen, Pneumonie und Pleuraempyem) [207]. [223]. Auch auf einer neonatologischen Abteilung beeinflusste die Gabe von 3.…”