Trends, Epidemiology, and Management of Multi-Drug Resistant Gram-Negative Bacterial Infections in the Hospitalized Setting

Abstract

The increasing prevalence of antibiotic resistance is a threat to human health, particularly within vulnerable populations in the hospital and acute care settings. This leads to increasing healthcare costs, morbidity, and mortality. Bacteria rapidly evolve novel mechanisms of resistance and methods of antimicrobial evasion. Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii have all been identified as pathogens with particularly high rates of resistance to antibiotics, resulting in a reducing pool of available treatments for these organisms. Effectively combating this issue requires both preventative and reactive measures. Reducing the spread of resistant pathogens, as well as reducing the rate of evolution of resistance is complex. Such a task requires a more judicious use of antibiotics through a better understanding of infection epidemiology, resistance patterns, and guidelines for treatment. These goals can best be achieved through the implementation of antimicrobial stewardship programs and the development and introduction of new drugs capable of eradicating multi-drug resistant Gram-negative pathogens (MDR GNB). The purpose of this article is to review current trends in MDR Gram-negative bacterial infections in the hospitalized setting, as well as current guidelines for management. Finally, new and emerging antimicrobials, as well as future considerations for combating antibiotic resistance on a global scale are discussed.

Expressed and Silent Carbapenemase Genes Detected by Multiplex PCR in both Carbapenem-Resistant and Phenotypically-Susceptible Gram Negative Bacilli

“…Infections attributed to GNB have been considerably escalating in the ICUs [3]. In the present study, lower respiratory tract infections were the most frequently encountered HAIs (42.11%), while wound infections came next at 32.6%, then urinary tract infections (25.26%).…”

“…In the meantime, due to the surging rates of resistance witnessed to commonly prescribed antibiotics, carbapenems have become the most substantial therapeutic option for handling infections caused by Gram-negative bacilli (GNB) [2]. Nonetheless, an alarming concern is the global spread and the cumulative prevalence of anti-microbial resistance to βlactam antibiotics (including carbapenems) among Pseudomonas aeruginosa, Acinetobacter baumannii as well as members of the Enterobacteriaceae family, which represents a life-threatening medical and public health issue [3].…”

Surviving Reactive Chlorine Stress: Responses of Gram-Negative Bacteria to Hypochlorous Acid

“…The emerging rise of antimicrobial resistant Gram-negative bacteria has become the major cause of concern for global public health [ 1 ]. In this context, an effective way to control bacterial colonization and spread is the use of disinfectants.…”

“…Gram-negative bacteria cause a wide range of serious infections, including pneumonia, urinary tract infections (UTIs), bloodstream, intra-abdominal, and wound infections [ 1 ]. Gram-negative pathogens are often more resistant to different classes of antibiotics than Gram-positive bacteria, mainly due to the presence of an impermeable outer membrane, which confers protection to the cells against hostile environmental conditions [ 3 , 4 ].…”

Distribution of Antibiotic-Resistant Enterobacteriaceae Pathogens in Potable Spring Water of Eastern Indian Himalayas: Emphasis on Virulence Gene and Antibiotic Resistance Genes in Escherichia coli

“…The presence of ARGs in human pathogens imposes a negative effect on health including failure of treatments, prolonged treatment periods, and in chronic cases deaths (Bueno et al, 2018). It is reported that about 7,00,000 peoples die each year due to the infection of ARB and that may increase up to 10,000,000 peoples per year by 2050 (Na et al, 2018;Morris and Cerceo, 2020).…”