Think (Gram) negative!
The increasing prevalence of multiresistant Gram-negative bacteria of the Enterobacteriaceae family in Europe is a worrisome phenomenon. Extended spectrum betalactamase-producing Escherichia coli strains are widespread in the community and are frequently imported into the hospital. Of even more concern is the spread of carbapenem-resistant strains of Klebsiella spp. from regions where they are already endemic. Antibiotic use is a main driver of antibiotic resistance, which again increases broad spectrum antibiotic use, resulting in a vicious circle that is difficult to interrupt. The present commentary highlights important findings of a surveillance study of antimicrobial use and resistance in German ICUs over 8 years with a focus on Gram-negative resistance.
Huttner
Benedikt
B
Infection Control Program, University of Geneva Hospitals and Medical School, CH-1211 Geneva 14, Switzerland. benedikt.huttner@hcuge.ch
Harbarth
Stephan
S
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D018432:Drug Resistance, Multiple; D005858:Germany; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy; D006801:Humans; D007362:Intensive Care Units; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'
D000900:Anti-Bacterial Agents