title: Executive summary of the diagnosis and antimicrobial treatment of invasive infections due to multidrug-resistant Enterobacteriaceae. Guidelines of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC).
abstract: The spread of multidrug-resistant Enterobacteriaceae related to the production of extended-spectrum β-lactamases (ESBL) and carbapenemases is a serious public health problem worldwide. Microbiological diagnosis and therapy of these infections are challenging and controversial. After the selection of clinically relevant questions, this document provides evidence-based recommendations for the use of microbiological techniques for the detection of ESBL- and carbapenemase-producing Enterobacteriaceae, and for antibiotic therapy for invasive infections caused by these organisms. The absence of randomized-controlled trials is noteworthy, thus recommendations are mainly based on observational studies, that have important methodological limitations, pharmacokinetic and pharmacodynamics models, and data from animal studies. Additionally, areas for future research were identified.
authors.affiliation: Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Seville, Spain; Departamento de Medicina, Universidad de Sevilla, Seville, Spain. Electronic address: jesusrb@us.es.
authors.forename: Jesús
authors.initials: J
authors.lastname: Rodríguez-Baño
authors.affiliation: Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Cisneros
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clinic, Barcelona, Spain.
authors.forename: Nazaret
authors.initials: N
authors.lastname: Cobos-Trigueros
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Gema
authors.initials: G
authors.lastname: Fresco
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Navarro-San Francisco
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge - ICO, Barcelona, Spain.
authors.forename: Carlota
authors.initials: C
authors.lastname: Gudiol
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario del Mar/Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Horcajada
authors.affiliation: Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Seville, Spain.
authors.forename: Lorena
authors.initials: L
authors.lastname: López-Cerero
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clinic, Barcelona, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Martínez
authors.affiliation: Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Seville, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Molina
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario del Mar/Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain.
authors.forename: Milagro
authors.initials: M
authors.lastname: Montero
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: José R
authors.initials: JR
authors.lastname: Paño-Pardo
authors.affiliation: Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Seville, Spain; Departamento de Microbiología, Universidad de Sevilla, Seville, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pascual
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge - ICO, Barcelona, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Peña
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Pintado
authors.affiliation: Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Seville, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Retamar
authors.affiliation: Servicio de Microbiología, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Tomás
authors.affiliation: Servicio de Medicina Intensiva, Hospital Son Llátzer, Palma de Mallorca, Spain.
authors.forename: Marcio
authors.initials: M
authors.lastname: Borges-Sa
authors.affiliation: Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain; Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Garnacho-Montero
authors.affiliation: Servicio de Microbiología, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain.
authors.forename: Germán
authors.initials: G
authors.lastname: Bou
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects*; D004756:Enterobacteriaceae Infections / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans
chemical_list: D000890:Anti-Infective Agents
keywords: Betalactamasas de espectro extendido; Carbapenemasas; Carbapenemases; Enterobacteriaceae multirresistentes; Extended-spectrum beta-lactamase; Guidelines; Guía; Multidrug-resistant Enterobacteriaceae; Therapy; Tratamiento