Infectious Disease Management of Multidrug-Resistant Gram-Negative Bacteria
Summary
Multidrug-resistant Gram-negative bacteria pose a significant global health threat due to their capacity to evade multiple antibiotic classes. Core strategies in managing these pathogens encompass robust surveillance programmes, rapid diagnostic methods and optimised antimicrobial stewardship. Surveillance employs molecular tools to detect resistance determinants such as extended-spectrum β-lactamases and carbapenemases, guiding empiric therapy. Rapid diagnostics, including mass spectrometry and nucleic acid amplification, shorten time to targeted treatment and reduce broad-spectrum antibiotic use. Therapeutic approaches combine existing agents—such as β-lactam/β-lactamase inhibitor combinations and intravenous colistin—with novel antibiotics and adjuvant therapies, including phage therapy and monoclonal antibodies. Infection prevention relies on strict hygiene, environmental decontamination and isolation protocols in healthcare settings. Global collaboration underpins the development of new antimicrobials and epidemiological data sharing, while antimicrobial stewardship integrates local resistance profiles into prescribing guidelines. Priorities include expanding access to rapid diagnostics, incentivising antibiotic development, and implementing stewardship at both community and hospital levels to preserve efficacy and limit the spread of high-risk clones.
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Infectious Disease Management of Multidrug-Resistant Gram-Negative Bacteria publication trend
The graph below shows the total number of articles in infectious disease management of multidrug-resistant gram-negative bacteria across all publications each year (not limited to Nature Index journals).
Technical terms
β-lactamase: An enzyme that hydrolyses the β-lactam ring of penicillins and cephalosporins, rendering these antibiotics ineffective.
Extended-spectrum β-lactamase (ESBL): A class of β-lactamases that confer resistance to oxyimino-cephalosporins and monobactams but are inhibited by clavulanic acid.
Carbapenemase: A β-lactamase capable of degrading carbapenem antibiotics, often associated with high-mortality infections.
Plasmid-mediated resistance: Transferable genetic elements that carry resistance genes between bacteria, accelerating the spread of multidrug resistance.
Extensively drug-resistant (XDR): Non-susceptibility to at least one agent in all but two or fewer antimicrobial categories, limiting treatment options.
Pandrug-resistant (PDR): Resistance to all agents in all antimicrobial categories, representing a critical therapeutic challenge.
References
- Early Release - Pseudomonas guariconensis Necrotizing Fasciitis, United Kingdom - Volume 30, Number 1—January 2024 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2024).
- Carbapenem-Resistant Organisms Isolated in Surgical Site Infections in Benin: A Public Health Problem. Tropical Medicine and Infectious Disease (2022).
- Pandrug-Resistant Acinetobacter baumannii Causing Nosocomial Infections in a University Hospital, Taiwan - Volume 8, Number 8—August 2002 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2002).
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