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The emerging threat of multidrug-resistant Gram-negative bacteria in urology
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The emerging threat of multidrug-resistant Gram-negative bacteria in urology
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Journal Article
The emerging threat of multidrug-resistant Gram-negative bacteria in urology
2015
Overview
Key Points
Multidrug-resistant Gram-negative pathogens are rapidly emerging and spreading globally
These multidrug-resistant pathogens are frequently associated with major pathologies, including urinary tract infections
Routine urological practices are affected by multidrug-resistant pathogens
Knowledge of the local epidemiology of multidrug-resistant Gram-negative bacteria is essential for determining empirical antimicrobial therapy
Urinary tract infections (UTIs) are very common and are a major contributor to global antibiotic use and resistance. Without effective antibiotics active against common uropathogens, many urological procedures would carry excessive risk. In this article, Zowawi and coauthors describe the current global epidemiology of resistance in Gram-negative uropathogens and discuss the genetic and molecular mechanisms underlying the resistance of these phenotypes. They also examine the effect of resistance on common urological procedures and summarize various preventive and therapeutic options.
Antibiotic resistance in Gram-negative uropathogens is a major global concern. Worldwide, the prevalence of Enterobacteriaceae that produce extended-spectrum β-lactamase or carbapenemase enzymes continues to increase at alarming rates. Likewise, resistance to other antimicrobial agents including aminoglycosides, sulphonamides and fluoroquinolones is also escalating rapidly. Bacterial resistance has major implications for urological practice, particularly in relation to catheter-associated urinary tract infections (UTIs) and infectious complications following transrectal-ultrasonography-guided biopsy of the prostate or urological surgery. Although some new drugs with activity against Gram-negative bacteria with highly resistant phenotypes will become available in the near future, the existence of a single agent with activity against the great diversity of resistance is unlikely. Responding to the challenges of Gram-negative resistance will require a multifaceted approach including considered use of current antimicrobial agents, improved diagnostics (including the rapid detection of resistance) and surveillance, better adherence to basic measures of infection prevention, development of new antibiotics and research into non-antibiotic treatment and preventive strategies.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Drug resistance in microorganisms
/ Drug Resistance, Multiple, Bacterial
/ Enzymes
/ Gram-Negative Bacteria - drug effects
/ Gram-negative bacterial infections
/ Gram-Negative Bacterial Infections - drug therapy
/ Gram-Negative Bacterial Infections - epidemiology
/ Gram-Negative Bacterial Infections - microbiology
/ Humans
/ Multidrug resistant organisms
/ Urinary Tract Infections - drug therapy
/ Urinary Tract Infections - epidemiology
/ Urinary Tract Infections - microbiology
/ Urology
