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Semin Respir Crit Care Med 2019; 40(04): 419-434
DOI: 10.1055/s-0039-1696662
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Difficult-to-Treat Antibiotic-Resistant Gram-Negative Pathogens in the Intensive Care Unit: Epidemiology, Outcomes, and Treatment

Jeffrey R. Strich
1   Critical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland
2   United States Public Health Service, Commissioned Corps, Rockville, Maryland
,
Sameer S. Kadri
1   Critical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland
› Author Affiliations Funding This work was supported by the Intramural Research Program of the National Institutes of Health Clinical Center.
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Publication History

Publication Date:
04 October 2019 (online)

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Abstract

Antibiotic resistance among gram-negative pathogens is a world-wide problem that poses a constant threat to patients in the intensive care unit and a therapeutic challenge for the intensivist. Furthermore, the substantial economic burden and increased mortality associated with infections due to highly resistant gram-negative pathogens exacerbate these challenges. Understanding the mechanisms, epidemiology, and risk factors for these infections is paramount to the successful control of outbreaks and for guiding therapy which often entails use of antibiotics with suboptimal efficacy and/or toxicity profiles. In this review we will discuss the global epidemiology, burden, risk factors, and treatment of highly resistant gram-negative infections as they apply to the intensive care population.

Keywords

gram-negative pathogens - antibiotic resistance - epidemiology - intensivist - Klebsiella pneumoniae

Disclaimer

The opinions expressed in this article are those of the authors and do not represent any position or policy of the National Institutes of Health, the U.S. Department of Health and Human Services, or the U.S. government.


 

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