Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2005 Apr 8:5:24.
doi: 10.1186/1471-2334-5-24.

Outcome of infections due to pandrug-resistant (PDR) Gram-negative bacteria

Matthew E Falagas  1 , Ioannis A Bliziotis, Sofia K Kasiakou, George Samonis, Panayiota Athanassopoulou, Argyris Michalopoulos
Affiliations
Case Reports

Outcome of infections due to pandrug-resistant (PDR) Gram-negative bacteria

Matthew E Falagas et al. BMC Infect Dis. .

Abstract

Background: The increasing problem of infections due to multidrug-resistant Gram-negative bacteria has led to re-use of polymyxins in several countries. However, there are already clinical isolates of Gram-negative bacteria that are resistant to all available antibiotics, including polymyxins.

Methods: We present a case series of patients with infections due to pathogens resistant to all antimicrobial agents tested, including polymyxins. An isolate was defined as pandrug-resistant (PDR) if it exhibited resistance to all 7 anti-pseudomonal antimicrobial agents, i.e. antipseudomonal penicillins, cephalosporins, carbapenems, monobactams, quinolones, aminoglycosides, and polymyxins.

Results: Clinical cure of the infection due to pandrug-resistant (PDR) Gram-negative bacteria, namely Pseudomonas aeruginosa or Klebsiella pneumoniae was observed in 4 out of 6 patients with combination of colistin and beta lactam antibiotics.

Conclusion: Colistin, in combination with beta lactam antibiotics, may be a useful agent for the management of pandrug-resistant Gram-negative bacterial infections. The re-use of polymyxins, an old class of antibiotics, should be done with caution in an attempt to delay the rate of development of pandrug-resistant Gram-negative bacterial infections.

PubMed Disclaimer

References

    1. Garnacho-Montero J, Ortiz-Leyba C, Jimenez-Jimenez FJ, Barrero-Almodovar AE, Garcia-Garmendia JL, Bernabeu-WittelI M, Gallego-Lara SL, Madrazo-Osuna J. Treatment of multidrug-resistant Acinetobacter baumannii ventilator-associated pneumonia (VAP) with intravenous colistin: a comparison with imipenem-susceptible VAP. Clin Infect Dis. 2003;36:1111–1118. doi: 10.1086/374337. - DOI - PubMed
    1. Michalopoulos AS, Tsiodras S, Rellos K, Mentzelopoulos S, Falagas ME. Colistin treatment in patients with ICU-acquired infections caused by multiresistant Gram-negative bacteria: the renaissance of an old antibiotic. Clin Microbiol Infect. 2005;11:115–121. doi: 10.1111/j.1469-0691.2004.01043.x. - DOI - PubMed
    1. Hsueh PR, Teng LJ, Chen CY, Chen WH, Yu CJ, Ho SW, Luh KT. Pandrug-resistant Acinetobacter baumannii causing nosocomial infections in a university hospital, Taiwan. Emerg Infect Dis. 2002;8:827–832. - PMC - PubMed
    1. Kuo LC, Yu CJ, Lee LN, Wang JL, Wang HC, Hsueh PR, Yang PC. Clinical features of pandrug-resistant Acinetobacter baumannii bacteremia at a university hospital in Taiwan. J Formos Med Assoc. 2003;102:601–606. - PubMed
    1. Denton M, Kerr K, Mooney L, Keer V, Rajgopal A, Brownlee K, Arundel P, Conway S. Transmission of colistin-resistant Pseudomonas aeruginosa between patients attending a pediatric cystic fibrosis center. Pediatr Pulmonol. 2002;34:257–261. doi: 10.1002/ppul.10166. - DOI - PubMed

Publication types

Substances