+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Multi-resistant Gram-negative bacilli: from epidemics to endemics

Multi-resistant Gram-negative bacilli: from epidemics to endemics

Current Opinion in Infectious Diseases 16(4): 315-325

Infections due to multi-drug resistant Gram-negative bacilli represent a worrying situation for the management of hospitalized patients. In addition, these bacteria are increasingly involved in epidemics throughout the world. This review focuses on recent data that may help to understand the emergence and dissemination of multi-drug resistant bacilli and the current trend from epidemic to endemic situations. Well-established clones enhance their resistance phenotype by the acquisition of new resistant genes, via gene capture genetic units (plasmids, transposons or integrons), thus facilitating the co-selective process under different antimicrobial selective pressures and therefore the long-term persistence of organisms in selective environments. Not only resistant bacterial clones are selected, but also their genetic structures carrying resistance genes. Therefore, current epidemiology of multi-drug resistant bacilli is not only focused on bacterial clones but also on any kind of resistance gene capture units. In this scenario a multiclonal population structure of bacterial organisms corresponds to a collection of different strains sharing resistance genes carried by horizontally transferred genetic structures. As different strains tend to prefer different environments, this concept helps understand why the epidemiology of multi-drug resistant Gram-negative bacilli is moving from epidemics to endemics. The emergence and spread of multi-drug resistant bacilli in the nosocomial setting should be understood in terms of a complex interplay of bacterial clonality, resistance genes and genetic structures promoting rapid dissemination of antimicrobial resistance. Intervention strategies in the forthcoming scenario should identify existing epidemic and/or endemic situations involving clonal organisms or resistance genes carried by epidemic gene capture units.

(PDF same-day service: $19.90)

Accession: 035349473

Download citation: RISBibTeXText

PMID: 12861084

DOI: 10.1097/01.qco.0000083566.48197.8b

Related references

Susceptibility of nosocomial urinary tract infections caused by multiply resistant gram-negative bacilli: potential use of antimicrobials "resistant" by disc-diffusion testing for controlling epidemics. Infection Control 1(3): 157-164, 1980

Epidemics of nosocomial urinary tract infection caused by multiply resistant gram negative bacilli epidemiology and control. Journal of Infectious Diseases 133(3): 363-366, 1976

Hospital infection by multi-resistant gram-negative bacilli. Journal of Antimicrobial ChemoTherapy 6(2): 168-170, 1980

Risk factors for acquisition of multi-drug resistant gram-negative bacilli. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 42: 335, 2002

Control of emergence of multi-resistant gram-negative bacilli by exclusive use of amikacin. American Journal of Medicine 80(6b): 71-75, 1986

Chloramphenicol - A Potent Armament Against Multi-Drug Resistant (MDR) Gram Negative Bacilli?. Journal of Clinical and Diagnostic Research 10(2): Dc01-Dc03, 2016

Sequential emergence of multi-resistant gram negative bacilli and preterm neonates mortality. Journal of Hospital Infection 40(SUPPL A): P3325, Sept, 1998

Increase in sepsis due to multi-resistant enteric gram-negative bacilli in Papua New Guinea. Lancet 353(9171): 2210-2211, 1999

Diagnostic and therapeutic problems in some cases of meningitis with multi-resistant gram negative bacilli. Neurologia, Psihiatria, Neurochirurgia 18(5): 443-452, 1973

Emerging issues in the management of infections caused by multi-drug-resistant, gram-negative bacilli. Surgical Infections 6 Suppl 2(): S-37-47, 2013

Multi-drug resistant gram negative bacilli causing early neonatal sepsis in India. Archives of Disease in Childhood. Fetal and Neonatal Edition 97(3): F182-F187, 2012

Susceptibility of multi-resistant Gram-negative bacilli in Singapore to tigecycline as tested by agar dilution. Annals of the Academy of Medicine, Singapore 36(10): 807-810, 2007

In vitro susceptibility of clinical isolates of multi resistant gram negative bacilli to trimethoprim sulfamethoxazole. Abstracts of the Annual Meeting of the American Society for Microbiology 85: 349, 1985

Multi-drug-resistant, non-fermenting, gram-negative bacilli in neonatal sepsis in Kolkata, India: a 4-year study. Paediatrics and International Child Health 34(1): 56-59, 2014

Comparison of pd 131628 pd ci 960 ci and other quinolones alone and in combination with extended spectrum beta lactams against multi resistant gram negative bacilli. Program & Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 31: 290, 1991