Multidrug-Resistant Sepsis: A Critical Healthcare Challenge

Abstract

Sepsis globally accounts for an alarming annual toll of 48.9 million cases, resulting in 11 million deaths, and inflicts an economic burden of approximately USD 38 billion on the United States healthcare system. The rise of multidrug-resistant organisms (MDROs) has elevated the urgency surrounding the management of multidrug-resistant (MDR) sepsis, evolving into a critical global health concern. This review aims to provide a comprehensive overview of the current epidemiology of (MDR) sepsis and its associated healthcare challenges, particularly in critically ill hospitalized patients. Highlighted findings demonstrated the complex nature of (MDR) sepsis pathophysiology and the resulting immune responses, which significantly hinder sepsis treatment. Studies also revealed that aging, antibiotic overuse or abuse, inadequate empiric antibiotic therapy, and underlying comorbidities contribute significantly to recurrent sepsis, thereby leading to septic shock, multi-organ failure, and ultimately immune paralysis, which all contribute to high mortality rates among sepsis patients. Moreover, studies confirmed a correlation between elevated readmission rates and an increased risk of cognitive and organ dysfunction among sepsis patients, amplifying hospital-associated costs. To mitigate the impact of sepsis burden, researchers have directed their efforts towards innovative diagnostic methods like point-of-care testing (POCT) devices for rapid, accurate, and particularly bedside detection of sepsis; however, these methods are currently limited to detecting only a few resistance biomarkers, thus warranting further exploration. Numerous interventions have also been introduced to treat MDR sepsis, including combination therapy with antibiotics from two different classes and precision therapy, which involves personalized treatment strategies tailored to individual needs. Finally, addressing MDR-associated healthcare challenges at regional levels based on local pathogen resistance patterns emerges as a critical strategy for effective sepsis treatment and minimizing adverse effects.

Risk Factors and Outcomes of Community-Acquired Carbapenem-Resistant Klebsiella pneumoniae Infection in Elderly Patients

“…Our study highlights that the patients with CRKP infection also had a significantly higher risk of other adverse outcomes, including ICU care, respiratory failure, and septic shock, which correlated with disease severity (i.e., SOFA score). The antibiotic-resistant strain is speculated to stimulate the production of pro- and anti-inflammatory cytokines, causing an imbalance between immune activation and immunosuppression, further immunological paralysis, and finally, inducing vital organ failure (e.g., encephalopathy, acute respiratory distress syndrome, acute kidney injury, and circulatory shock) [ 23 ]. The elderly are more susceptible to these infections owing to their immunosenescence and decline in vital organ function; therefore, the CRKP group, unsurprisingly, had a higher risk of these adverse outcomes.…”

Antibacterial and Wound Healing Efficacy of Silver Nanoparticles Synthesized from Root Bark ofBerberis lyciumRoyle

“…In spite of advancements in antibiotic therapies, the upsurge of multidrug-resistant bacteria has highlighted the critical need for alternative antimicrobial agents and wound healing modalities. [7] Among the range of strategies, nano-material utilization has garnered considerable attention due to their unique physicochemical properties and capable biomedical applications.…”

Antiseptic Functions of CGK012 against HMGB1-Mediated Septic Responses

“…Inhibiting the secretion of HMGB1 from damaged cells and stimulated immunocytes may therefore be a promising strategy for the treatment of lethal septic diseases. The latest clinical guidelines for sepsis management emphasize early recognition and intervention, prompt administration of appropriate antibiotics, fluid resuscitation, and hemodynamic support to optimize patient outcomes [ 9 ]. These guidelines stress the importance of timely assessment and risk stratification, along with close monitoring of vital signs and laboratory parameters.…”

“…These guidelines stress the importance of timely assessment and risk stratification, along with close monitoring of vital signs and laboratory parameters. Additionally, they advocate for the use of bundled care approaches, such as the “sepsis bundle” or “sepsis protocol”, which outline specific interventions to be implemented within a defined timeframe [ 9 ]. Furthermore, the guidelines highlight the importance of source control, adequate organ support, and ongoing reassessment to guide therapy adjustments.…”

“…Furthermore, the guidelines highlight the importance of source control, adequate organ support, and ongoing reassessment to guide therapy adjustments. Overall, the current standards of sepsis care prioritize a multidisciplinary, evidence-based approach aimed at improving patient survival and reducing morbidity associated with septic shock and organ dysfunction [ 9 ]. During sepsis, several inflammatory biomarkers play crucial roles in diagnosis, prognosis, and guiding treatment decisions.…”