Management of ventilator-associated pneumonia (VAP) caused by resistant gram-negative bacteria: which is the best strategy to treat?

Management of ventilator-associated pneumonia (VAP) caused by resistant gram-negative bacteria: which is the best strategy to treat? Expert Rev Respir Med. 2019 Jun 18;: Authors: Sarda C, Fazal F, Rello J Abstract Introduction: Treatment of ventilator-associated pneumonia (VAP) is a major challenge. The increase in multi-drug resistant bacteria has not been accompanied by the validation of new drugs, or by any new antimicrobial strategies to exploit the available agents. VAP due to Gram-negative bacteria has increased mortality, both due to the resistant pathogens themselves and due to inappropriate treatment. Local epidemiology, patients' characteristics and clinical responses provide the most important information for therapeutic decision-making. Moreover, data on VAP therapy due to resistant bacteria are lacking, and the choice of treatment is often based on clinical practice and individual experience. Areas covered: This review summarizes the strategies available for treating the three most prevalent resistant Gram-negative organisms causing VAP: Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacteriaceae. The review covers the results of a Pubmed search, clinical practice guidelines and reviews, and the authors' experience. Expert opinion: The existing evidence focuses on bloodstream infections or other sites rather than pneumonia and there are no recommendations for the treatment of VAP by multi-drug resistant Gram-negative bacteria, espe...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

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Abstract Nosocomial infections have become alarming with the increase of multidrug-resistant bacterial strains of Acinetobacter baumannii. Being the causative agent in ~80% of the cases, these pathogenic gram-negative species could be deadly for hospitalized patients, especially in intensive care units utilizing ventilators, urinary catheters, and nasogastric tubes. Primarily infecting an immuno-compromised system, they are resistant to most antibiotics and are the root cause of various types of opportunistic infections including but not limited to septicemia, endocarditis, meningitis, pneumonia, skin, and wound s...
Source: Genomics Proteomics ... - Category: Genetics & Stem Cells Authors: Tags: Front Cell Infect Microbiol Source Type: research
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Source: Natural Product Research - Category: Biochemistry Authors: Tags: Nat Prod Res Source Type: research
ConclusionSevere community-acquired pneumonia was treated with macrolides in combination with vancomycin or linezolid if methicillin-resistant S. aureus was suspected. This was appropriate, in view of its causative agents and their susceptibility pattern. Hospital and ventilator-associated pneumonia caused by resistant Gram-negative organisms might have better outcomes by adding tigecycline or colistin in combination with fluoroquinolones. Owing to the widespread resistance of many Gram-negative bacteria, it is recommended that the antibiotic stewardship program be frequently updated.
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
Nosocomial infections have become alarming with the increase of multidrug resistant bacterial strains of Acinetobacter baumannii. Being the causative agent in approximately 80% of the cases, these pathogenic gram-negative species could be deadly for hospitalized patients, especially in intensive care units utilizing ventilators, urinary catheters and nasogastric tubes. Primarily infecting an immuno-compromised system, they are resistant to most antibiotics and are the root cause of various types of opportunistic infections including but not limited to septicemia, endocarditis, meningitis, pneumonia, skin and wound sepsis a...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
AbstractVentilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in critically ill patients. Here, we employed the broad antibacterial effects of sphingosine to prevent VAP by developing a novel method of coating surfaces of endotracheal tubes with sphingosine and sphingosine analogs. Sphingosine and phytosphingosine coatings of endotracheal tubes prevent adherence and mediate killing ofPseudomonas aeruginosa,Acinetobacter baumannii, andStaphylococcus aureus, even in biofilms. Most importantly, sphingosine-coating of endotracheal tubes also preventedP. aeruginosa andS. aureus pneumonia in vivo. Coa...
Source: Journal of Molecular Medicine - Category: Molecular Biology Source Type: research
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Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
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Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
Abstract Acinetobacter baumannii is a major cause of nosocomial infections especially hospital-acquired pneumonia. This bacterium readily acquires antibiotic resistance traits and therefore, new treatment alternatives are urgently needed. The virulence of A. baumannii linked to iron acquisition suggests a potential for new anti-infectives that target its iron acquisition. DIBI is a purpose-designed, iron-sequestering, anti-microbial that has shown promise for treating microbial infection. DIBI was investigated for its in vitro and in vivo activities against clinical A. baumannii isolates. DIBI was inhibitory for a...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research
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Source: Future Microbiology - Category: Microbiology Authors: Source Type: research
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