Rafael Cantón1,2, Desirèe Gijón1,2, Patricia Ruiz-Garbajosa1,2. 1. Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). 2. Spanish Network for the Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III, Madrid, Spain.
Abstract
PURPOSE OF REVIEW: To describe current antimicrobial resistance in ESKAPE Gram-negative microorganisms and their situation in the ICUs, the implication of the so-called high-risk clones (HiRCs) involved in the spread of antimicrobial resistance as well as relevance of the COVID-19 pandemic in the potential increase of resistance. RECENT FINDINGS: Extended-spectrum and carbapenemase producing Enterobacterales and multidrug and extensive drug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii have increased worldwide. Sequence type (ST)131 Escherichia coli, ST258, ST11, ST10, ST147 and ST307 Klebsiella pneumoniae, ST111, ST175, ST235 and ST244 P. aeruginosa HiRCs are responsible for this increase in the ICUs, and some of them are implicated in the emergence of resistance mechanisms affecting new antimicrobials. A similar situation can be found with European clonal complex 1 and clonal complex 2 of A. baumannii. The high use of antimicrobials during the COVID-19 pandemic, particularly in ICUs, might have a negative influence in future trends of antimicrobial resistance. SUMMARY: The increase of antimicrobial resistance in ICUs is mainly due to the spread of HiRCs and is exemplified with the ESKAPE Gram-negative microorganisms. The COVID-19 pandemic might have a negative impact in the increase of antimicrobial resistance and should be monitored through specific surveillance studies in ICUs.
PURPOSE OF REVIEW: To describe current antimicrobial resistance in ESKAPE Gram-negative microorganisms and their situation in the ICUs, the implication of the so-called high-risk clones (HiRCs) involved in the spread of antimicrobial resistance as well as relevance of the COVID-19 pandemic in the potential increase of resistance. RECENT FINDINGS: Extended-spectrum and carbapenemase producing Enterobacterales and multidrug and extensive drug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii have increased worldwide. Sequence type (ST)131 Escherichia coli, ST258, ST11, ST10, ST147 and ST307 Klebsiella pneumoniae, ST111, ST175, ST235 and ST244 P. aeruginosa HiRCs are responsible for this increase in the ICUs, and some of them are implicated in the emergence of resistance mechanisms affecting new antimicrobials. A similar situation can be found with European clonal complex 1 and clonal complex 2 of A. baumannii. The high use of antimicrobials during the COVID-19 pandemic, particularly in ICUs, might have a negative influence in future trends of antimicrobial resistance. SUMMARY: The increase of antimicrobial resistance in ICUs is mainly due to the spread of HiRCs and is exemplified with the ESKAPE Gram-negative microorganisms. The COVID-19 pandemic might have a negative impact in the increase of antimicrobial resistance and should be monitored through specific surveillance studies in ICUs.
Authors: Jorge Calderón-Parra; Antonio Muiño-Miguez; Alejandro D Bendala-Estrada; Antonio Ramos-Martínez; Elena Muñez-Rubio; Eduardo Fernández Carracedo; Javier Tejada Montes; Manuel Rubio-Rivas; Francisco Arnalich-Fernandez; Jose Luis Beato Pérez; Jose Miguel García Bruñén; Esther Del Corral Beamonte; Paula Maria Pesqueira Fontan; Maria Del Mar Carmona; Rosa Fernández-Madera Martínez; Andrés González García; Cristina Salazar Mosteiro; Carlota Tuñón de Almeida; Julio González Moraleja; Francesco Deodati; María Dolores Martín Escalante; María Luisa Asensio Tomás; Ricardo Gómez Huelgas; José Manuel Casas Rojo; Jesús Millán Núñez-Cortés Journal: PLoS One Date: 2021-05-11 Impact factor: 3.240
Authors: Jesús Rodríguez-Baño; Gian Maria Rossolini; Constance Schultsz; Evelina Tacconelli; Srinivas Murthy; Norio Ohmagari; Alison Holmes; Till Bachmann; Herman Goossens; Rafael Canton; Adam P Roberts; Birgitta Henriques-Normark; Cornelius J Clancy; Benedikt Huttner; Patriq Fagerstedt; Shawon Lahiri; Charu Kaushic; Steven J Hoffman; Margo Warren; Ghada Zoubiane; Sabiha Essack; Ramanan Laxminarayan; Laura Plant Journal: Trans R Soc Trop Med Hyg Date: 2021-10-01 Impact factor: 2.184