期刊
CURRENT OPINION IN CRITICAL CARE
卷 24, 期 5, 页码 385-393出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCC.0000000000000534
关键词
Acinetobacter baumannii; carbapenem-producing Enterobacteriaceae; extended-spectrum beta-lactamase-producing Enterobacteriaceae; ICU; methicillin-resistant Staphylococcus aureus; multidrug-resistant Gram-negative infections; pneumonia; Pseudomonas aeruginosa
Purpose of reviewDescribe the risk factors and discuss the management of multidrug-resistant (MDR) bacteria responsible for pneumonia among critically ill patients, including methicillin-resistant Staphylococcus aureus, extended spectrum beta-lactamase-producing Enterobactericeae, carbapenem-resistant Enterobactericeae, multidrug resistant Pseudomonas aeruginosa, and Acinetobacter baumannii.Recent findingsMultiple factors have been associated with infections because of MDR bacteria, including prolonged hospital stay, presence of invasive devices, mechanical ventilation, colonization with resistant pathogens, and use of broad-spectrum antibiotics. Management of these infections includes the prompt use of appropriate antimicrobial therapy, implementation of antimicrobial stewardship protocols, and targeted active microbiology surveillance. Combination therapy and novel molecules have been used for the treatment of severe infections caused by resistant bacteria.SummaryThe exponential increase of antimicrobial resistance among virulent pathogens currently represents one of the main challenges for clinicians in the intensive care unit. Knowledge of the local epidemiology, patient risk stratification, and infection-control policies remain key elements for the management of MDR infections. Results from clinical trials on new molecules are largely awaited.
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