MDROs—The New Age Challenge

Abstract

In continuation with our article on "Antimicrobial resistance profile in ICUs of tertiary care hospital-a worrisome state of affairs," I want to stress on alarming rise of multidrug-resistant organisms (MDROs) in our hospital. 1 This study shows that 80% Enterobacteriaceae isolated from ICUs are resistant to the third-generation cephalosporins and more than 90% Staphylococcus aureus isolated are MRSA, i.e., methicillin-resistant S. aureus. A bulk of hospital-acquired infections are caused by Acinetobacter baumannii and Pseudomonas aeruginosa showing 80% of resistance to carbapenems which is much more than seen in other tertiary care hospitals. 2 According to a study published in the Lancet, in 2010, India was the largest consumer of antibiotics in the world with almost 13 billion units followed by China with 10 billion units and the US with almost 7 billion units. 3 Large amounts of antibiotics used for human therapy, as well as for farm animals and even for fish in aquaculture, have resulted in the selection of pathogenic bacteria resistant to multiple drugs. Experts say that if the problem of drug-resistant diseases is not tackled, it will mark a return to old days of people dying from common infections.MDROs are defined as microorganisms, predominantly bacteria, that are resistant to one or more antimicrobial agents in three or more different classes of antimicrobials that the isolate is expected to be susceptible. 4 The morbidity and mortality rates associated with MDRO infections are high. Stringent infection control strategies should be developed to prevent and control spread of MDROs and to minimize the cross infection to other patients, staff, and visitors.Prevention and control strategies for MDROs.A two-level approach has been recommended for the prevention and control of MDROs: