Multidrug-Resistant Bacteria in the Community

Abstract

Multidrug resistant (MDR) bacteria are one of the most important current threats to public health. Typically, MDR bacteria are associated with nosocomial infections. However, some MDR bacteria have become quite prevalent causes of community-acquired infections. The spread of MDR bacteria into the community is a crucial development, and is associated with increased morbidity, mortality, healthcare costs and antibiotic use. Factors associated with community dissemination of MDR bacteria overlap but are distinct from those associated with nosocomial spread. Community-associated (CA) MDR bacteria have an antibiotic resistance phenotype that is stable in the absence of antibiotic pressure of the type normally observed in hospitals or nursing homes. An exception to this rule may be those CA-MDR bacteria, of which the prevalence is driven by the presence of antibiotics in the food chain. Additionally, the colonization of otherwise healthy hosts is a common characteristic of CA-MDR bacteria. However, subtle immune deficiencies may still be present in the subjects colonized with specific CA-MDR bacteria. Methicillin-resistant S. aureus (MRSA) is the most prevalent of CA-MDR bacteria. CA-MRSA also has the greatest impact on morbidity and mortality. The main threat on the horizon is represented by Enterobacteriaceae. The production of extended spectrum β-lactamases in Enterobacteriaceae encountered in the community is becoming increasingly prevalent. Of great concern is the potential for the acquisition of carbapenemase genes in CA-Enterobacteriaceae. Prevention of further community spread of MDR bacteria is of the utmost importance, and will require a multi-disciplinary approach involving all stakeholders.

Probabilistic model for the estimation of the consumer exposure to methicillin‐resistant Staphylococcus aureus due to cross‐contamination and recontamination

“…In recent decades, the presence of multidrug-resistant bacteria has been considered as a major concern in public health (van Duin & Paterson, 2016), reducing the efficacy of antimicrobial treatments (Li & Webster, 2018) and contributing to more than 25,000 deaths in the European Union (EU) each year (Cassini et al., 2019). A wellknown example of bacteria that is resistant to a number of antibiotics is the methicillin-resistant Staphylococcus aureus (MRSA).…”

Charged Metallopolymer-Grafted Silica Nanoparticles for Antimicrobial Applications

“…Antimicrobial resistance has been highlighted as “one of the greatest threats to human health worldwide” by the Infectious Diseases Society of America, and the White House announced the National Strategy for Combating Antibiotic-Resistant Bacteria (CARB). 1 According to U.S. Centers for Disease Control and Prevention, at least 2 million people are affected annually by drug-resistant bacteria in the U.S. alone, and 23,000 of them lose their lives. 2 The burden created by these infections on the economy is also substantial and is estimated to result in $20 billion in additional health care costs and $35 billion in lost productivity annually.…”

Antibody-Based Immunotherapy To Treat and Prevent Infection with Hypervirulent Klebsiella pneumoniae

“…Recent work with MAbs to the polysaccharide poly-(␤-1,6)-N-acetylglucosamine are encouraging (41), and future studies should be done comparing efficacy of MAbs with differences in degree of microbial specificity. The spread of multidrug-resistant (MDR) bacteria in the community as exemplified now by MDR hvKp is a crucial development, associated not only with increased morbidity, mortality, and health care costs but also with inappropriate antibiotic use (42). Our findings may have broader implications, because treatment with anti-infective MAbs against a gut-colonizing bacteria like hvKp is a targeted intervention that should not disturb the microbiome, promote resistance, or lead to emergence of other serotypes.…”