Ali Pourmand1, Maryann Mazer-Amirshahi2, Gregory Jasani3, Larissa May4. 1. Department of Emergency Medicine, The George Washington University, Washington, DC, United States; The George Washington University, School of Medicine and Health Sciences, Washington, DC, United States. Electronic address: apourmand@mfa.gwu.edu. 2. Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC, United States; Georgetown University School of Medicine, Washington, DC, United States. 3. Department of Emergency Medicine, The George Washington University, Washington, DC, United States; The George Washington University, School of Medicine and Health Sciences, Washington, DC, United States. 4. Department of Emergency Medicine, UC Davis, Davis, CA, United States.
Abstract
BACKGROUND: Many bacteria are demonstrating increasing levels of resistance to commonly used antibiotics. While this has implications for the healthcare system as a whole, many patients infected with these resistant organisms will initially present to the emergency department (ED). The purpose of this review is to provide a summary of current trends in infections caused by the most clinically relevant resistant organisms encountered in emergency medicine. METHODS: Bacteria were selected based on the Centers for Disease Control and Prevention's National Action Plan for Combating Antibiotic Resistant Bacteria, and PubMed database. RESULTS: The following bacteria were included: methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci, Escherichia coli, carbapenem-resistant Enterobacteriaceae, Neisseria gonorrhoeae, and Pseudomonas aeruginosa. All have shown increasing rates of resistance to one or more of the antibiotics commonly used to treat them. Increasing rates of antibiotic resistance are associated with worse clinical outcomes and greater healthcare costs. CONCLUSIONS: Antibiotic resistance is increasing and poses significant a risk to both the patient and public health as a whole. Appropriate choice of initial antibiotic is important in improving clinical outcomes, which is often the role of the ED provider. On a broader level, the ED must also take part in institutional efforts such as Antibiotic Stewardship Programs, which have been shown to decrease costs and rates of infection with resistant organisms. Ultimately, a multifaceted approach will be required to curb the threat of antibiotic-resistant bacteria.
BACKGROUND: Many bacteria are demonstrating increasing levels of resistance to commonly used antibiotics. While this has implications for the healthcare system as a whole, many patients infected with these resistant organisms will initially present to the emergency department (ED). The purpose of this review is to provide a summary of current trends in infections caused by the most clinically relevant resistant organisms encountered in emergency medicine. METHODS: Bacteria were selected based on the Centers for Disease Control and Prevention's National Action Plan for Combating Antibiotic Resistant Bacteria, and PubMed database. RESULTS: The following bacteria were included: methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci, Escherichia coli, carbapenem-resistant Enterobacteriaceae, Neisseria gonorrhoeae, and Pseudomonas aeruginosa. All have shown increasing rates of resistance to one or more of the antibiotics commonly used to treat them. Increasing rates of antibiotic resistance are associated with worse clinical outcomes and greater healthcare costs. CONCLUSIONS: Antibiotic resistance is increasing and poses significant a risk to both the patient and public health as a whole. Appropriate choice of initial antibiotic is important in improving clinical outcomes, which is often the role of the ED provider. On a broader level, the ED must also take part in institutional efforts such as Antibiotic Stewardship Programs, which have been shown to decrease costs and rates of infection with resistant organisms. Ultimately, a multifaceted approach will be required to curb the threat of antibiotic-resistant bacteria.
Authors: Yuanyuan Qian; Giuseppe Allegretta; Jeshina Janardhanan; Zhihong Peng; Kiran V Mahasenan; Elena Lastochkin; Melissa Malia N Gozun; Sara Tejera; Valerie A Schroeder; William R Wolter; Rhona Feltzer; Shahriar Mobashery; Mayland Chang Journal: J Med Chem Date: 2020-05-08 Impact factor: 7.446
Authors: Rakel Arrazuria; Bernhard Kerscher; Karen E Huber; Jennifer L Hoover; Carina Vingsbo Lundberg; Jon Ulf Hansen; Sylvie Sordello; Stephane Renard; Vincent Aranzana-Climent; Diarmaid Hughes; Philip Gribbon; Lena E Friberg; Isabelle Bekeredjian-Ding Journal: Front Microbiol Date: 2022-09-08 Impact factor: 6.064