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Chapter 10 : Global Spread of Multidrug-Resistant Gram-Negative Bacilli

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Global Spread of Multidrug-Resistant Gram-Negative Bacilli, Page 1 of 2

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Abstract:

This chapter describes three emerging issues with multiply resistant gram-negative bacilli, each of which has worldwide importance. First, community-onset infections with CTX-M-15-producing threaten to permanently alter empiric antibiotic choices for urinary tract infection (UTI). Second, producing the carbapenemase (KPC) are now spreading from their epicenter in New York City to multiple parts of the globe and are complicating management of infections in hospitals and nursing homes. Finally, global dissemination of carbapenem-resistant underscores the epidemic potential of successful bacterial lineages. The antibiotic resistance phenotype of the ST131-positive is that the organisms are typically resistant to ceftriaxone, cefotaxime, fluoroquinolones, trimethoprim, trimethoprim-sulfamethoxazole, penicillin/beta-lactamase inhibitor combinations, and tetracyclines. Resistance to aminoglycosides is variable. The clone confers multidrug resistance by the presence of multiple antibiotic resistance genes. As can be expected by the resistance profile of ST131 , treatment options are limited. The isolates are often susceptible to nitrofurantoin, pivmecillinam, and fosfomycin. Interspecies spread of the KPC gene has been documented in a single patient with , , and . The most important mechanism of antibiotic resistance in is production of beta-lactamases. and isolates with resistance to polymyxins and sometimes all antibiotic options have now been detected. If these strains were to spread widely, it is likely that significant mortality would be observed.

Citation: Paterson D, Sidjabat H, Doi Y. 2010. Global Spread of Multidrug-Resistant Gram-Negative Bacilli, p 213-222. In Scheld W, Grayson M, Hughes J (ed), Emerging Infections 9. ASM Press, Washington, DC. doi: 10.1128/9781555816803.ch10

Key Concept Ranking

Outer Membrane Proteins
0.5010494
beta-Lactam Antibiotics
0.49887872
beta-Lactamase Inhibitors
0.48745918
Urinary Tract Infections
0.462871
0.5010494
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References

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Tables

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Table 1.

Common and emerging antibiotic resistance issues in gram-negative bacilli

Citation: Paterson D, Sidjabat H, Doi Y. 2010. Global Spread of Multidrug-Resistant Gram-Negative Bacilli, p 213-222. In Scheld W, Grayson M, Hughes J (ed), Emerging Infections 9. ASM Press, Washington, DC. doi: 10.1128/9781555816803.ch10

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