Risk stratification for multidrug-resistant Gram-negative infections in ICU patients.

Abstract:

PURPOSE OF REVIEW:Antimicrobial resistance among Gram-negative microorganisms has alarmingly increased in the past 10 years worldwide. Infections caused by these microorganisms are difficult to treat, especially in critically ill patients.The present review examines how to accurately predict which patients carry a greater risk of colonization or infection on which to base the timely choice of an effective empirical antibiotic treatment regimen and avoid antibiotic overuse. RECENT FINDINGS:There are many risk factors for acquiring one of many multidrug-resistant Gram-negative microorganisms (MDR-GN); however, scores anticipating colonization, infection among those colonized, or mortality among those infected have a variable accuracy. Accuracy of scores anticipating colonization is low. Scores predicting infections among colonized patients are, in general, better, and ICU patients infected with MDR-GN have a worse prognosis than those infected by non-resistant microorganisms. Scores are, in general, better at excluding patients. SUMMARY:Despite these limitations, scores continue to gain popularity including those by Giannella, Tumbarello, Johnson, or the scores INCREMENT carbapenem-producing Enterobacteriaceae score, Cano, Tartof, or CarbaSCORE.

journal_name

Curr Opin Infect Dis

authors

Burillo A,Muñoz P,Bouza E

doi

10.1097/QCO.0000000000000599

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

626-637

issue

6

eissn

0951-7375

issn

1473-6527

journal_volume

32

pub_type

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