multidrug-resistant gram-negative bacteria; multidrug-resistant enterobacteriaceae (MRE)
Jump to navigation
Jump to search
Epidemiology
- most prevalent in long-term acute care hospitals[5]
- also observed in community
- carbapenem-resistant organisms are emerging
- carbapenem-resistance (India, Pakistan) conferred by New Delhi metallo-beta-lactamase 1 (emergence in 2010)
- increase in multidrug- & carbapenem-resistant Pseudomonas aeruginosa infections in U.S. children 1999-2012[2]
Pharmacology
- resistant to beta-lactams*
- often resistant to aminoglycosides & fluoroquinolones
* also see extended spectrum beta lactamase (ESBL)
Management
- carbapenem if resistant to resistant to beta-lactams aminoglycosides & fluoroquinolones
- colistin if carbapenem-resistant
- prevention
- antimicrobial stewardship
- adhere to hand-hygiene protocols[5]
- maintain contact precautions throughout hospitalization after 1st detected[3]
- clean & disonfect environment & equipment[5]
More general terms
Additional terms
References
- ↑ Prescriber's Letter 18(7): 2011 Resistant Gram-negative Bacteria Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=270713&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 2.0 2.1 Logan LK, Gandra S, Mandal S et al Multidrug- and Carbapenem-Resistant Pseudomonas aeruginosa in Children, United States, 1999-2012. J Ped Infect Dis (2016) Published online Nov 16 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27856730
- ↑ 3.0 3.1 Banach DB, Bearman G, Barnden M et al Duration of Contact Precautions for Acute-Care Settings. Infection Control & Hospital Epidemiology. Jan 11, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29321078 https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/duration-of-contact-precautions-for-acutecare-settings/94E38FDCE6E1823BD613ABE4E8CB5E56
- ↑ Cilloniz C, Gabarrus A, Ferrer M et al Community-Acquired Pneumonia Due to Multidrug- and Non-Multidrug- Resistant Pseudomonas aeruginosa. Chest. 2016 Aug;150(2):415-25. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27060725
- ↑ 5.0 5.1 5.2 5.3 Medical Knowledge Self Assessment Program (MKSAP) 19. American College of Physicians, Philadelphia 2021