Insights and Opinions of Critical Care Healthcare Professionals in the Management of Carbapenem-resistant Enterobacteriaceae Cases and Antibiotic-Resistant Infections in the Intensive Care Unit Setting: A Survey-Based Approach.

Autor:	Pandit RA; Chairman, Department of Critical Care, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India, Corresponding Author., Vijayakumar PC; Chief Anaestheiologist and Critical Care Physician, Department of Anesthesia and Critical Care, Sooriya Hospital, Chennai, Tamil Nadu, India., Shah M; Chief Intensivist, Department of Critical Care, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India., Jha S; Senior Intensivist, Department of Critical Care, Pushpawati Singhania Research Center, Delhi, India., Patil B; Head of Department, Department of Pulmonology, Dr Prabhakar Kore KLE Hospital and Research Center, Belagavi, Karnataka, India., Dwivedy A; Chief Intensivist, Department of Critical Care, Dr L H Hiranandani Hospital, India., Patil K; Consultant Physician and Intensivist, Department of Medicine, S L Raheja Fortis Hospital, Mumbai, India., Nerli RB; Director, Department of Urology, Dr Prabhakar Kore KLE Hospital and Research Center, Belagavi, Karnataka, India., Kulkarni A; Consultant Physician and Intensivist, Department of Critical Care, Seth Nandlal Dhoot Hospital, Aurangabad, Maharashtra, India., Vinod NK; Head of Department, Department of Anesthesia and Critical Care, Shri Shankara Cancer Hospital & Research Centre (SSCHRC), Bengaluru, Karnataka, India., Nikalje A; Consultant Physician and Intensivist, Department of Critical Care, MGM Hospital, Aurangabad, Maharashtra, India., Jain A; Consultant Physician and Intensivist, Department of Medicine, Maharaja Agrasen Hospital, Siliguri, West Bengal, India., Lakkappan VG; Chief Intensivist, Department of Critical Care, Holyfamily Hospital, Mumbai, Maharashtra, India., Parakh RK; Professor, Department of Medicine, SDM College of Medical Science, Dharwad, Karnataka, India., Chafekar DS; Head of Department, Department of Nephrology, Chafekar Healthcare, Nashik, Maharashtra, India.
Jazyk:	angličtina
Zdroj:	The Journal of the Association of Physicians of India [J Assoc Physicians India] 2024 Jan; Vol. 72 (1), pp. 43-46.
DOI:	10.59556/japi.71.0442
Abstrakt:	Introduction: A survey-based approach to managing antibiotic-resistant infections in the intensive care unit (ICU) setting, with a focus on carbapenem-resistant Enterobacteriaceae (CRE) cases, was conducted. Among CRE, New Delhi metallo-β-lactamase 1 (NDM-1) is a carbapenemase that is resistant to β-lactam antibiotics and has a broader spectrum of antimicrobial resistance than other carbapenemase types. The article explains that healthcare-associated infections (HAIs) are a significant problem, particularly in low- and middle-income countries, and that carbapenem in combination with other antibiotics are the most potent class of antimicrobial agents effective in treating life-threatening bacterial infections, including those caused by resistant strains. Aim: The survey aimed to gather critical care healthcare professionals (HCPs') opinions on their current practices in managing infections acquired in the hospital and ICU settings, with a focus on CRE cases, specifically NDM-1 and other antibiotic-resistant infections. Methods: Responses from critical care healthcare professionals, including online surveys and in-person interviews, to gain insights into the management of infections caused by multidrug-resistant bacteria. The findings related to the insights on the prevalence of bacterial flora, clinical experiences on efficacy and safety of meropenem sulbactam ethylenediaminetetraacetic acid (EDTA) (MSE) in CRE cases, and various combination therapies of antibiotics used to treat antibiotic-resistant infections in ICU setting were evaluated. Results: Klebsiella pneumoniae bacteria were the most common bacteria in cultures, followed by Escherichia coli , Pseudomonas aeruginosa , and Acinetobacter baumannii . NDM-1 was the type of carbapenemase found in around 50% of CRE patients. MSE is among the most preferred antibiotics besides colistin, polymyxin B, and ceftazidime avibactum for CRE cases and specifically for NDM-1 cases due to its high rate of efficacy and safety. Conclusion: The article concludes with a discussion on the antibiotics used in response to CRE cases, reporting that critical care HCP considers MSE with high efficacy and safe antibiotic combination and was used as both monotherapy and in combination with other antibiotics. The survey highlights the need for exploring and better understanding the role of MSE in the management of CRE infections, especially in NDM-1. (© Journal of the Association of Physicians of India 2024.)
Databáze:	MEDLINE
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