Outcome of infections due to pandrug-resistant (PDR) Gram-negative bacteria

Falagas, Matthew E.; Bliziotis, Ioannis A.; Kasiakou, Sofia K.; Samonis, George; Athanassopoulou, Panayiota; Michalopoulos, Argyris

doi:10.1186/1471-2334-5-24

Cited by 202 publications

(191 citation statements)

References 23 publications

(21 reference statements)

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“…Despite the growth of MDR strains, very few antimicrobials have been developed to combat these infections (Rubinstein, Vaughan, 2005). The growing body of evidence also proves the development of resistant gram-negative infections without adequate therapeutic options (Falagas et al, 2005). Moreover, MDR gramnegative infections are associated with increased mortality rates, extended durations of hospitalization, and higher healthcare costs (Bergman et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial susceptibility patterns among bacteria isolated from intensive care units of the largest teaching hospital at the northwest of Iran

Hamishehkar

Shadmehr

Mahmoodpoor

et al. 2016

Braz. J. Pharm. Sci.

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This study was conducted to determine the antimicrobial susceptibility patterns among common pathogens in the intensive care units (ICUs) of a university hospital in northwestern Iran. A retrospective study was done on laboratory records of patients with nosocomial infection who were admitted to five ICUs of Imam Reza Hospital during a 21-month period from March 2010 to January, 2012. A total number of 556 isolates from 328 patients were evaluated. The most common sites of infections included respiratory (51.7%), urinary (24.8%), and blood (10.4%). The most frequently isolated microorganisms were Enterobacter aerogenes (50.6%) followed by Escherichia coli (16.7%) and Pseudomonas aeruginosa (7.5%). Staphylococcus aureus was the most frequent pathogen among gram-positives (39.7%). The rate of methicillin-resistant Staphylococcus aureus (MRSA) was 87.5%. Multidrug-resistant (MDR) gram-negative bacteria were documented in 25.8% of Acinetobacter, 20% of Klebsiella, and 16.6% of Pseudomonas. The most active antimicrobials were vancomycin (93.5%) followed by amikacin (71.5%) and gentamicin (46%). The overall antibiotic susceptibility was as follows: 36% ciprofloxacin, 19% imipenem, 20% trimethoprim-sulfamethoxazole, 20.5% ceftazidime, and 12% ceftriaxone. Due to the high rate of antimicrobial resistance in the ICU setting, more surveillance and control of the use of antimicrobials is needed to combat infections. Uniterms:Intensive care units/anti-infective agents/cross infection. Hospital University/Iran. INTRODUCTION Patients a d m i t t e d t o intensive care units (ICUs)are more vulnerable to various nosocomial infections because of their underlying illnesses and exposure to various invasive medical devices (Jatin, Mary, 2012;Archibald et al., 1997;Fridkin, 2001;Kollef, Fraser, 2001;Rhomberg et al., 2006).Hospital infections affect approximately two million patients annually and lead to 90,000 deaths and a cost of $4.5 to $5.7 billion according to reports from the United States (Weinstein, 1998;Jarvis, 2001). They involve 5-10% of ICU patients (CDC, 1992;Stone, Larson, Kawar, 2002).Antibiotics are the mainstay tools in the management of infections. Disappointingly, a number of studies have reported inappropriate uses of antimicrobials as well as the emergence of antibiotic resistance in most parts of the world (Tunger et al., 2009; Bergman et al., 2006). Today, the emergence of multidrug-resistant (MDR) gramnegative and methicillin-resistant Staphylococcus aureus (MRSA) pathogens has become a major public health concern. Moreover, they negatively influence patients' outcomes and increase the length of hospital stays and healthcare costs (Giske et al., 2008;De Kraker et al., 2011;Resch, Wilke, Fink, 2009;Mulvey, Simor, 2009).Many studies have also showed that controlled use of antibiotics leads to improved microorganism sensitivity H. Hamishehkar, P. Shadmehr, A. Mahmoodpoor, S. O. Mashayekhi, T. Entezari-Maleki 404 to antimicrobial agents (Lee et al., 2010;Takesue et al., 2010). The emergence of resistant pathogens ...

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Section: Discussionmentioning

confidence: 99%

Antimicrobial susceptibility patterns among bacteria isolated from intensive care units of the largest teaching hospital at the northwest of Iran

Hamishehkar

Shadmehr

Mahmoodpoor

et al. 2016

Braz. J. Pharm. Sci.

View full text Add to dashboard Cite

show abstract

“…More-conservative estimates are obtained by means of noncomparative methods, such as the appropriateness evaluation protocol, in which the effect of infection with MRSA is ascertained for each patient individually. 5 It would be very helpful if Cosgrove and colleagues included more-conservative estimates in their data set.…”

Section: Impact Of Methicillin-resistant Staphylococcus Aureus Infectmentioning

confidence: 99%

Impact of Methicillin-Resistant Staphylococcus aureus Infection on Morbidity and Costs in Healthcare Facilities

Verbrugh

2006

Infect. Control Hosp. Epidemiol.

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“…Panresistance is increasingly being reported in Gram negative microbes [6,11]. The South and South-East Asia region (SEAR) has one of the highest prevalence of tuberculosis with one death every few minutes [12].…”

Section: Introductionmentioning

confidence: 99%