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The increasing threat from antibiotic-resistant bacteria

Politicians and public health experts are increasingly concerned by the implications for healthcare systems around the world of highly antibiotic-resistant Gram-negative bacteria, including Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa.

In the USA and Europe there is real concern about carbapenem-resistant enterobacteriaceae (CREs) – or carbapenemase-producing enterobacteriaceae (CPEs). But in many of the developing markets such as the Middle East, Latin America or Asia, there are strains of Gram-negative bacteria which are resistant to all antibiotics including the 'last line of defence' antibiotics: the carbapenems and Colistin. In other words, hospitals in some regions of the world are seeing ‘pan-resistant’ – or untreatable - bacteria. (And the European CDC recently reported problems in Italy with Colistin resistance)

The good news is that some of the better known Gram-positive bacteria – such as MRSA and Clostridium difficile – are showing declines on the back of a bundle of measures including improved hand hygiene, better environmental cleaning and carefully managed antibiotic stewardship. This has been particularly notable in the UK. Further, there are still five classes of antibiotics effective against these Gram-positive bacteria – with further Gram-positive antimicrobials in the drug development pipeline.

Unfortunately, the bad news is that same cannot be said for Gram-negative bacteria. They are a real and deteriorating problem. (Click here for more information on CREs and CPEs)

The World Health Organisation published a document in April 2014, highlighting the risks to healthcare systems around the world of these highly resistant Gram-negative bacteria. This was followed by a warning highlighting the threat of antibiotic resistance from the British Prime Minister in July 2014. There was also an announcement of an antibiotic-resistance strategy and other initiatives from the Obama White House in September 2014.   Moreover, the European Centre for Disease Control and Prevention – ECDC – published in November 2014 a worrying update on the growth in antibiotic resistance in Europe – and in particular among Gram-negative bacteria. In short, the problems for healthcare providers – and especially acute care hospitals - associated with antibiotic-resistance particularly in relation to Gram-negative bacteria, are becoming more severe: both clinically and economically.

 
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