Pathogen prevalence, emerging threats, and regional resistance patterns
Panelists discuss emerging therapies for multidrug-resistant Gram-negative pathogens, focusing on the rising threat of antimicrobial resistance, evolving resistance mechanisms like extended-spectrum β-lactamases (ESBLs) and New Delhi metallo-β-lactamases (NDMs), regional variability in pathogen prevalence, and the clinical implications for treatment in inpatient and outpatient settings.
The peer exchange titled “Turning the Tide on Resistance: Emerging Therapies for Multidrug-Resistant Gram-Negative Pathogens” gathers experts in infectious diseases to address the growing challenge of antimicrobial resistance, particularly among Gram-negative organisms. The discussion is moderated by a pharmacist and researcher specializing in multidrug-resistant infections, and features insights from professionals in pediatrics, outpatient care, microbiology, and clinical research. The panel sets the stage for a conversation that covers the current landscape of resistant pathogens, the mechanisms driving their resistance, and the promise of emerging treatments.
A central theme in the discussion is the rising prevalence of ESBL-producing organisms, such as Escherichia coli and Klebsiella pneumoniae, which complicate treatment due to limited oral antibiotic options. The experts also highlight the shift in carbapenem-resistant organisms, with NDMs gaining ground over K pneumoniae carbapenemases (KPCs) in US hospitals. These trends pose significant clinical challenges, especially in outpatient settings where oral treatments are preferred, and for intensive care unit patients dealing with highly resistant strains like Pseudomonas and Acinetobacter. Despite these challenges, new antibiotics are becoming available that offer hope for more effective treatment options.
Another key point is the regional variability of resistance patterns, even among hospitals in the same city. For example, institutions across Boston, Massachusetts, report different dominant resistant strains, ranging from KPCs to NDMs. This variability underscores the importance of local surveillance and tailored empirical therapy based on institutional epidemiology. It also emphasizes that the burden of resistant pathogens is influenced by patient populations, such as those from long-term care facilities or with international exposure, which can significantly affect local resistance trends and treatment strategies.
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