title: The Challenge of Antimicrobial Resistance in Managing Intra-Abdominal Infections.
abstract: BACKGROUND
  In recent years, there has been a worldwide increase in infections caused by microorganisms resistant to multiple antimicrobial agents.
  
  
  METHODS
  In the past few decades, an increased prevalence of infections caused by antibiotic-resistant pathogens, including Enterococcus spp., carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii, extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp., carbapenemase-producing Klebsiella pneumoniae, and resistant Candida spp., also has been observed among intra-abdominal infections (IAIs).
  
  
  RESULTS
  The increasing prevalence of multi-drug resistance is responsible for a substantial increase in morbidity and mortality rates associated with IAIs.
  
  
  CONCLUSIONS
  It is necessary for every surgeon treating IAIs to understand the underlying epidemiology and clinical consequences of antimicrobial resistance. Emergence of drug resistance, combined with the lack of new agents in the drug development pipeline, indicates that judicious antimicrobial management will be necessary to preserve the utility of the drugs available currently.
authors.affiliation: 1Department of Surgery, Macerata Hospital, Macerata, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Sartelli
authors.affiliation: 2Department of Emergency Surgery, Maggiore Hospital, Parma, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Catena
authors.affiliation: 3Department of Surgery, Maggiore Hospital, Bologna, Italy.
authors.forename: Salomone
authors.initials: S
authors.lastname: di Saverio
authors.affiliation: 4General Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Ansaloni
authors.affiliation: 4General Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Coccolini
authors.affiliation: 1Department of Surgery, Macerata Hospital, Macerata, Italy.
authors.forename: Cristian
authors.initials: C
authors.lastname: Tranà
authors.affiliation: 5Department of Surgery, University Hospital Southampton, Southampton, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Kirkby-Bott
mesh_terms: D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D002177:Candidiasis / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D059413:Intraabdominal Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D015995:Prevalence