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RESEARCH ARTICLE

The rise and rise of antimicrobial resistance in Gram-negative bacteria

Adam Stewart A , Hugh Wright A and Krispin Hajkowicz A
+ Author Affiliations
- Author Affiliations

Infectious Diseases, Royal Brisbane and Women’s Hospital, Brisbane, Qld, Australia Tel: 0427 858 102, Email: Krispin.Hajkowicz@health.qld.gov.au

Microbiology Australia 40(2) 62-65 https://doi.org/10.1071/MA19018
Published: 18 April 2019

Abstract

Antimicrobial resistance is a major threat to the delivery of effective care and already causes 700000 excess deaths per year worldwide. International consensus on action to combat antimicrobial resistance was reached in 2015. Australia is implementing a national strategy. The clinical consequences of antimicrobial resistance are seen most acutely in multi-drug resistant Gram-negative bacterial infections, where they cause increased mortality and morbidity and threaten the delivery of once routine medical care. The solution to antimicrobial resistance is complex and multifaceted. Antimicrobial stewardship, that is optimising the use of the antibiotics we currently have, is the most rapidly deployable mitigation. Several novel antibiotics with activity against a range of drug-resistant bacteria are now available clinically, leading to hope that innovative solutions will reduce the impact of resistance. It is critical that these new drugs are protected from inappropriate use.


References

[1]  Van Goethem, M.W. et al. (2018) A reservoir of ‘historical’ antibiotic resistance genes in remote pristine Antarctic soils. Microbiome 6, 40.
A reservoir of ‘historical’ antibiotic resistance genes in remote pristine Antarctic soils.Crossref | GoogleScholarGoogle Scholar | 29471872PubMed |

[2]  Abraham, E.P. and Chain, E. (1988) An enzyme from bacteria able to destroy penicillin. Rev. Infect. Dis. 10, 677–678.
| 3055168PubMed |

[3]  Rammelkamp, T. (1942) Resistance of Staphylococcus aureus to the action of penicillin. Exp. Biol. Med. 51, 386–389.
Resistance of Staphylococcus aureus to the action of penicillin.Crossref | GoogleScholarGoogle Scholar |

[4]  O’Neill, J. (2016). Tackling drug-resistant infections globally: final report and recommendations. The Review on Antimicrobial Resistance. HM Government of the United Kingdom, London.

[5]  Commonwealth of Australia (2015) Responding to the Threat of Antimicrobial Resistance. Australia’s First National Antimicrobial Resistance Strategy 2015–2019. Canberra: Commonwealth of Australia.

[6]  Peleg, A.Y. and Hooper, D.C. (2010) Hospital-acquired infections due to Gram-negative bacteria. N. Engl. J. Med. 362, 1804–1813.
Hospital-acquired infections due to Gram-negative bacteria.Crossref | GoogleScholarGoogle Scholar | 20463340PubMed |

[7]  Harris, P. et al. (2015) Facing the challenge of multidrug-resistant gram-negative bacilli in Australia. Med. J. Aust. 202, 243–247.
Facing the challenge of multidrug-resistant gram-negative bacilli in Australia.Crossref | GoogleScholarGoogle Scholar | 25758692PubMed |

[8]  World Health Organization (2014) Antimicrobial resistance – global report on surveillance. https://apps.who.int/iris/bitstream/handle/10665/112642/9789241564748_eng.pdf;jsessionid=519244EE0EEF520027CE4098504150B4?sequence=1

[9]  Rogers, B.A. et al. (2014) Predictors of use of infection control precautions for multiresistant Gram-negative bacilli in Australian hospitals: analysis of a national survey. Am. J. Infect. Control 42, 963–969.
Predictors of use of infection control precautions for multiresistant Gram-negative bacilli in Australian hospitals: analysis of a national survey.Crossref | GoogleScholarGoogle Scholar | 25179327PubMed |

[10]  Corcione, S. et al. (2018) Epidemiology and risk factors for mortality in bloodstream infection by CP-Kp, ESBL-E, Candida and CDI: a single center retrospective study. Eur. J. Intern. Med. 48, 44–49.
Epidemiology and risk factors for mortality in bloodstream infection by CP-Kp, ESBL-E, Candida and CDI: a single center retrospective study.Crossref | GoogleScholarGoogle Scholar | 29096992PubMed |

[11]  Emmanuel Martinez, A. et al. (2019) ESBL-colonization at ICU admission: impact on subsequent infection, carbapenem-consumption, and outcome. Infect. Control Hosp. Epidemiol. , .
ESBL-colonization at ICU admission: impact on subsequent infection, carbapenem-consumption, and outcome.Crossref | GoogleScholarGoogle Scholar | 30786948PubMed |

[12]  Xu, L. (2017) Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae. Ann. Clin. Microbiol. Antimicrob. 16, 18.
Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae.Crossref | GoogleScholarGoogle Scholar | 28356109PubMed |

[13]  Zhang, Y. et al. (2016) Mortality attributable to carbapenem-resistant Pseudomonas aeruginosa bacteremia: a meta-analysis of cohort studies Emerg. Microbes Infect. 5, e27.
Mortality attributable to carbapenem-resistant Pseudomonas aeruginosa bacteremia: a meta-analysis of cohort studiesCrossref | GoogleScholarGoogle Scholar | 27780970PubMed |

[14]  Chiotos, K. et al. (2018) Increased 30-day mortality associated with carbapenem-resistant Enterobacteriaceae in children Open Forum Infect. Dis. 5, ofy222.
Increased 30-day mortality associated with carbapenem-resistant Enterobacteriaceae in childrenCrossref | GoogleScholarGoogle Scholar | 30338267PubMed |

[15]  Biehl, L.M. et al. (2016) Colonization and infection with extended spectrum beta-lactamase producing Enterobacteriaceae in high-risk patients – review of the literature from a clinical perspective. Crit. Rev. Microbiol. 42, 1–16.
Colonization and infection with extended spectrum beta-lactamase producing Enterobacteriaceae in high-risk patients – review of the literature from a clinical perspective.Crossref | GoogleScholarGoogle Scholar | 24495097PubMed |

[16]  Barbier, F. et al. (2016) Colonization and infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae in ICU patients: what impact on outcomes and carbapenem exposure? J. Antimicrob. Chemother. 71, 1088–1097.
Colonization and infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae in ICU patients: what impact on outcomes and carbapenem exposure?Crossref | GoogleScholarGoogle Scholar | 26755492PubMed |

[17]  Girmenia, C. et al. (2015) Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy Bone Marrow Transplant. 50, 282–288.
Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from ItalyCrossref | GoogleScholarGoogle Scholar | 25310302PubMed |

[18]  Dubinsky-Pertzov, B. et al. (2018) Carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae and the risk of surgical site infection after colorectal surgery: a prospective cohort study. Clin. Infect. Dis. , ciy768.
| 30204851PubMed |

[19]  Thaden, J.T. et al. (2017) Increased costs associated with bloodstream infections caused by multidrug-resistant Gram-negative bacteria are due primarily to patients with hospital-acquired infections. Antimicrob. Agents Chemother. 61, e01709-16.
Increased costs associated with bloodstream infections caused by multidrug-resistant Gram-negative bacteria are due primarily to patients with hospital-acquired infections.Crossref | GoogleScholarGoogle Scholar | 28373189PubMed |

[20]  Australian Commission on Safety and Quality in Health Care (ACQSHC) (2016). AURA 2016 – First Australian report on antimicrobial use and resistance in human health. Sydney: ACSQHC. https://www.safetyandquality.gov.au/publications/aura-2016-first-australian-report-on-antimicroibal-use-and-resistance-in-human-health/ (accessed 20 March 2019).

[21]  Bush, K. and Page, M.G. (2017) What we may expect from novel antibacterial agents in the pipeline with respect to resistance and pharmacodynamic principles. J. Pharmacokinet. Pharmacodyn. 44, 113–132.
What we may expect from novel antibacterial agents in the pipeline with respect to resistance and pharmacodynamic principles.Crossref | GoogleScholarGoogle Scholar | 28161807PubMed |

[22]  Zhanel, G.G. et al. (2014) Ceftolozane/tazobactam: a novel cephalosporin/b-lactamase inhibitor combination with activity against multidrug-resistant Gram-negative bacilli. Drugs 74, 31–51.
Ceftolozane/tazobactam: a novel cephalosporin/b-lactamase inhibitor combination with activity against multidrug-resistant Gram-negative bacilli.Crossref | GoogleScholarGoogle Scholar | 24352909PubMed |

[23]  Li, H. et al. (2015) In vitro susceptibility of characterized β-lactamase-producing strains tested with avibactam combinations. Antimicrob. Agents Chemother. 59, 1789–1793.
In vitro susceptibility of characterized β-lactamase-producing strains tested with avibactam combinations.Crossref | GoogleScholarGoogle Scholar | 25534728PubMed |

[24]  Möllmann, U. et al. (2009) Siderophores as drug delivery agents: application of the ‘Trojan Horse’ strategy. Biometals 22, 615–624.
Siderophores as drug delivery agents: application of the ‘Trojan Horse’ strategy.Crossref | GoogleScholarGoogle Scholar | 19214755PubMed |

[25]  ClinicalTrials.gov (2016) Study of S-649266 or best available therapy for the treatment of severe infections caused by carbapenem-resistant Gram-negative pathogens (CREDIBLE e CR). https://clinicaltrials.gov/ct2/show/NCT02714595 (accessed March 2019).

[26]  Wagenlehner, F.M.E. et al. (2019) Once-daily plazomicin for complicated urinary tract infections. N. Engl. J. Med. 380, 729–740.
Once-daily plazomicin for complicated urinary tract infections.Crossref | GoogleScholarGoogle Scholar |

[27]  McKinnell, J.A. et al. (2019) Plazomicin for infections caused by carbapenem-resistant Enterobacteriaceae. N. Engl. J. Med. 380, 791–793.
Plazomicin for infections caused by carbapenem-resistant Enterobacteriaceae.Crossref | GoogleScholarGoogle Scholar | 30786196PubMed |

[28]  Shields, R.K. et al. (2016) Clinical outcomes, drug toxicity, and emergence of ceftazidime-avibactam resistance among patients treated for carbapenem-resistant Enterobacteriaceae infections. Clin. Infect. Dis. 63, 1615–1618.
Clinical outcomes, drug toxicity, and emergence of ceftazidime-avibactam resistance among patients treated for carbapenem-resistant Enterobacteriaceae infections.Crossref | GoogleScholarGoogle Scholar | 27624958PubMed |