| Autor: |
Maseda E; Emilio Maseda, Anesthesiology and Surgical Critical Care Dpt., Hospital La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain. emilio.maseda@gmail.com., Mensa J, Valía JC, Gomez-Herreras JI, Ramasco F, Samso E, Chiveli MA, Pereira J, González R, Aguilar G, Tamayo G, Ojeda N, Rico J, Gimenez MJ, Aguilar L |
| Jazyk: |
angličtina |
| Zdroj: |
Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia [Rev Esp Quimioter] 2013 Dec; Vol. 26 (4), pp. 312-31. |
| Abstrakt: |
ICUs are areas where resistance problems are the largest, and they constitutes a major problem for the intensivist's clinical practice. Main resistance phenotypes among nosocomial microbiota are: i) vancomycin-resistance/heteroresistance and tolerance in grampositives (MRSA, enterococci) and ii) efflux pumps/enzymatic resistance mechanisms (ESBLs, AmpC, metallobetalactamases) in gramnegatives. These phenotypes are found at different rates in pathogens causing respiratory (nosocomial pneumonia/ventilator-associated pneumonia), bloodstream (primary bacteremia/catheter-associated bacteremia), urinary, intraabdominal and surgical wound infections and endocarditis in the ICU. New antibiotics are available to overcome non-susceptibility in grampositives; however, accumulation of resistance traits in gramnegatives has lead to multidrug resistance, a worrisome problem nowadays. This article reviews by microorganism/infection risk factors for multidrug resistance, suggesting adequate empirical treatments. Drugs, patient and environmental factors all play a role in the decision to prescribe/recommend antibiotic regimens in the specific ICU patient, implying that intensivists should be familiar with available drugs, environmental epidemiology and patient factors. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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