Severe infections caused by difficult-to-treat Gram-negative bacteria

Abstract

Purpose of review Antimicrobial resistance (AMR) in Gram-negative bacteria (GNB) poses a significant global health concern, contributing to increased infections, mortality rates, and healthcare costs. This review discusses the main clinical manifestations, therapeutic options, and recent findings in managing antibiotic-resistant GNB, with a focus on difficult-to-treat infections. Recent findings Difficult-to-treat resistance (DTR) is a novel classification that identifies GNB exhibiting intermediate or resistant phenotypes to first-line agents in the carbapenem, beta-lactam, and fluoroquinolone categories. The main pathogens implicated in severe infections include DTR Enterobacterales, DTR Pseudomonas aeruginosa, and DTR Acinetobacter baumannii. Although the clinical implications of DTR strains are still under investigation, certain studies have linked them to prolonged hospital stays and poor patient outcomes. Summary Severe infections caused by DTR-GNB pose a formidable challenge for healthcare providers and represent a growing global health issue. The proper administration and optimization of novel antibiotics at our disposal are of paramount importance for combating bacterial resistance and improving patient prognosis.

Increase in Incidence Rates and Risk Factors for Multidrug Resistant Bacteria in Septic Children: A Nationwide Spanish Cohort Study (2013–2019)

“…Patients' demographic characteristics are summarized in Table 1. Overall, patients with sepsis had a median age of 11 months [4-55 months] and a PRISM III score 24 h after admission of 7 [3][4][5][6][7][8][9][10][11][12]. One hundred and forty-one (32.6%) patients had received antibiotic treatment in the 48 h prior to PICU admission.…”

“…Currently, antimicrobial resistance in Gram-negative bacteria is a growing threat in Europe and worldwide [2,3]. The ability of these bacteria to acquire and modify new genetic material that confers on them new resistance mechanisms is a cause of great concern, especially in children, because of the more limited availability of antimicrobials in pediatric patients [4].…”

AMP-Coated TiO2 Doped ZnO Nanomaterials Enhanced Antimicrobial Activity and Efficacy in Otitis Media Treatment by Elevating Hydroxyl Radical Levels

“…As AMR problem worsens, there is a lack of ideal medications for otitis media treatment, and severe cases may result in hearing impairment. [6][7][8][9] To tackle this, researchers have been striving to develop novel antibiotic alternatives, such as zinc oxide nanoparticles (ZnO NPs), titanium dioxide nanoparticles (TiO 2 NPs), and antimicrobial peptides (AMPs). Each of these drugs has its own strengths in antibacterial properties, yet they also come with their own limitations.…”

Risk stratification and survival time of patients with gram-negative bacillary pneumonia in the intensive care unit

“…With the widespread use of broad-spectrum antibiotics, the incidence of infections with multidrug-resistant gram-negative bacilli has increased ( Cillóniz et al., 2019 ), significantly worsening the survival rate of infected patients. Gram-negative bacilli infections have become a major challenge to global public health ( Kanj et al., 2022 ; Dettori et al., 2023 ). Studies have shown that the mortality rate of gram-negative bacillary pneumonia is 14.5%-32% ( Feng et al., 2019 ; Kofteridis et al., 2020 ).…”