title: Important aspects of nosocomial bacterial resistance and its management.
abstract: The article reviews management of nosocomial bacterial resistance aspects. Nosocomial infections are associated with substantial morbidity, mortality and cost. During the last several decades multi-drug resistant organisms increased in number considerably. Methicillin-resistant staphylococcus aureus, Vancomycin-intermediately resistant staphylococcus aureus and fully vancomycin-resistant staphylococcus aureus evolved as a consequence of methicillin and vancomycin use. The introduction of third generation cephalosporins were followed by emergence of extended spectrum and AMP-C -lactamases among gram negative bacteria, and carbapenems were targeted by carbapenemases. The poor diagnostic yield of current microbiologic methods in identifying certain resistant organisms, combined with decreasing numbers of newly developed antibiotics pose a significant challenge to physicians. We reviewed some of the approaches which can be followed to maximize the positive clinical outcome in patients with resistant nosocomial infections, using currently available antibiotics. More sensitive microbiological methods and new types of antibiotics are needed to adequately address the problem in the future.
authors.affiliation: Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.
authors.forename: G
authors.initials: G
authors.lastname: Kandelaki
authors.forename: T
authors.initials: T
authors.lastname: Tsertsvadze
authors.forename: N
authors.initials: N
authors.lastname: Macharashvili
authors.forename: M
authors.initials: M
authors.lastname: Esugbaia
authors.forename: Sh
authors.initials: Sh
authors.lastname: Gogichaishvili
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001419:Bacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D003428:Cross Infection / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents