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Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns
Bacterial pneumonia is one of the most serious public health issues owing to its medical and economic costs, which result in increased morbidity and mortality in people of all ages around the world. Furthermore, antimicrobial resistance has risen over time, and the advent of multi-drug resistance in...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9069761/ https://www.ncbi.nlm.nih.gov/pubmed/35509063 http://dx.doi.org/10.1186/s41479-022-00096-z |
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author | Assefa, Muluneh |
author_facet | Assefa, Muluneh |
author_sort | Assefa, Muluneh |
collection | PubMed |
description | Bacterial pneumonia is one of the most serious public health issues owing to its medical and economic costs, which result in increased morbidity and mortality in people of all ages around the world. Furthermore, antimicrobial resistance has risen over time, and the advent of multi-drug resistance in GNB complicates therapy and has a detrimental impact on patient outcomes. The current review aimed to summarize bacterial pneumonia with an emphasis on gram-negative etiology, pathogenesis, risk factors, resistance mechanisms, treatment updates, and vaccine concerns to tackle the problem before it causes a serious consequence. In conclusion, the global prevalence of GNB in CAP was reported 49.7% to 83.1%, whereas in VAP patients ranged between 76.13% to 95.3%. The most commonly reported MDR-GNB causes of pneumonia were A. baumannii, K. pneumoniae, and P. aeruginosa, with A. baumannii isolated particularly in VAP patients and the elderly. In most studies, ampicillin, tetracyclines, amoxicillin-clavulanic acid, cephalosporins, and carbapenems were shown to be highly resistant. Prior MDR-GNB infection, older age, previous use of broad-spectrum antibiotics, high frequency of local antibiotic resistance, prolonged hospital stays, ICU admission, mechanical ventilation, and immunosuppression are associated with the MDR-GNB colonization. S. maltophilia was reported as a severe cause of HAP/VAP in patients with mechanically ventilated and having hematologic malignancy due to its ability of biofilm formation, site adhesion in respiratory devices, and its intrinsic and acquired drug resistance mechanisms. Effective combination therapies targeting PDR strains and drug-resistant genes, antibiofilm agents, gene-based vaccinations, and pathogen-specific lymphocytes should be developed in the future. |
format | Online Article Text |
id | pubmed-9069761 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-90697612022-05-05 Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns Assefa, Muluneh Pneumonia (Nathan) Review Bacterial pneumonia is one of the most serious public health issues owing to its medical and economic costs, which result in increased morbidity and mortality in people of all ages around the world. Furthermore, antimicrobial resistance has risen over time, and the advent of multi-drug resistance in GNB complicates therapy and has a detrimental impact on patient outcomes. The current review aimed to summarize bacterial pneumonia with an emphasis on gram-negative etiology, pathogenesis, risk factors, resistance mechanisms, treatment updates, and vaccine concerns to tackle the problem before it causes a serious consequence. In conclusion, the global prevalence of GNB in CAP was reported 49.7% to 83.1%, whereas in VAP patients ranged between 76.13% to 95.3%. The most commonly reported MDR-GNB causes of pneumonia were A. baumannii, K. pneumoniae, and P. aeruginosa, with A. baumannii isolated particularly in VAP patients and the elderly. In most studies, ampicillin, tetracyclines, amoxicillin-clavulanic acid, cephalosporins, and carbapenems were shown to be highly resistant. Prior MDR-GNB infection, older age, previous use of broad-spectrum antibiotics, high frequency of local antibiotic resistance, prolonged hospital stays, ICU admission, mechanical ventilation, and immunosuppression are associated with the MDR-GNB colonization. S. maltophilia was reported as a severe cause of HAP/VAP in patients with mechanically ventilated and having hematologic malignancy due to its ability of biofilm formation, site adhesion in respiratory devices, and its intrinsic and acquired drug resistance mechanisms. Effective combination therapies targeting PDR strains and drug-resistant genes, antibiofilm agents, gene-based vaccinations, and pathogen-specific lymphocytes should be developed in the future. BioMed Central 2022-05-05 /pmc/articles/PMC9069761/ /pubmed/35509063 http://dx.doi.org/10.1186/s41479-022-00096-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Review Assefa, Muluneh Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns |
title | Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns |
title_full | Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns |
title_fullStr | Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns |
title_full_unstemmed | Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns |
title_short | Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns |
title_sort | multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9069761/ https://www.ncbi.nlm.nih.gov/pubmed/35509063 http://dx.doi.org/10.1186/s41479-022-00096-z |
work_keys_str_mv | AT assefamuluneh multidrugresistantgramnegativebacterialpneumoniaetiologyriskfactorsanddrugresistancepatterns |