Bugs, hosts and ICU environment: countering pan-resistance in nosocomial microbiota and treating bacterial infections in the critical care setting.

Data de publicació:

Autors de IIS La Fe

Autors aliens a IIS La Fe

  • Maseda E
  • Mensa J
  • Valia JC
  • Gomez-Herreras JI
  • Ramasco F
  • Samso E
  • Pereira J
  • Gonzalez R
  • Aguilar G
  • Tamayo G
  • Ojeda N
  • Rico J
  • Gimenez MJ
  • Aguilar L

Abstract

ICUs are areas where resistance problems are the largest, and these constitute a major problem for the intensivist's clinical practice. Main resistance phenotypes among nosocomial microbiota are (i) vancomycin-resistance/heteroresistance and tolerance in grampositives (MRSA, enterococci) and (ii) efflux pumps/enzymatic resistance mechanisms (ESBLs, AmpC, metallo-betalactamases) in gramnegatives. These phenotypes are found at different rates in pathogens causing respiratory (nosocomial pneumonia/ventilator-associated pneumonia), bloodstream (primary bacteremia/catheter-associated bacteremia), urinary, intraabdominal and surgical wound infections and endocarditis in the ICU. New antibiotics are available to overcome non-susceptibility in grampositives; however, accumulation of resistance traits in gramnegatives has led to multidrug resistance, a worrisome problem nowadays. This article reviews microorganism/infection risk factors for multidrug resistance, suggesting adequate empirical treatments. Drugs, patient and environmental factors all play a role in the decision to prescribe/recommend antibiotic regimens in the specific ICU patient, implying that intensivists should be familiar with available drugs, environmental epidemiology and patient factors.

Dades de la publicació

ISSN/ISSNe:
0034-9356, 2340-3284

Revista espanola de anestesiologia y reanimacion  ELSEVIER SCIENCE BV

Tipus:
Article
Pàgines:
1-19
PubMed:
24492197
Factor d'Impacte:
0,195 SCImago
Quartil:
Q3 SCImago

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Keywords

  • Acinetobacter baumannii; Betalactamasas de espectro prolongado; Critical care; Cuidados criticos; Enterococo resistente a vancomicina; Extended spectrum beta-lactamase; Methicillin-resistant Staphylococcus aureus; Pseudomonas aeruginosa; Staphycoccus aureus resistente a meticilina; Vancomycin-resistant enterococci

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