Epidemiology of antimicrobial resistance in bloodstream infections

Abstract

Antimicrobial resistance in bacterial pathogens is a worldwide challenge leading high morbidity and mortality in clinical settings. Multidrug resistant patterns in gram-positive and -negative bacteria have resulted in difficult-to-treat or even untreatable infections with conventional antimicrobials. Since the early identification of causative microorganisms and their antimicrobial susceptibility patterns in patients with bacteremia and other serious infections is lacking in many healthcare institutions, broad spectrum antibiotics are liberally and mostly unnecessarily used. Such practice has, in turn, caused dramatic increases in emerging resistance and when coupled with poor practice of infection control, resistant bacteria can easily be disseminated to the other patients and the environment. Thus, availability of updated epidemiological data on antimicrobial resistance in frequently encountered bacterial pathogens will be useful not only for deciding on empirical treatment strategies, but also devising an effective antimicrobial stewardship program in hospitals.

Keywords: antimicrobial resistance; antimicrobial stewardship; bloodstream infection; multidrug resistance.

Figure 1.

Data shown on the graph are obtained from the following sources: Australia: Australian Group on Antimicrobial Resistance (AGAR). Available at http://www.agargroup.org, France, Germany, Greece, UK: European Antimicrobial Resistance Surveillance Network (EARS Net). Available at http://www.ersnet.org, Turkey: The data for the period of 2003–2008 are derived from EARSS European Antimicrobial Resistance Surveillance System (EARSS) available at http://www.rivm.nl. For 2009–2010; personal communication with Dolunay Gulmez, M.D. For 2011–2013; from National Antimicrobial Resistance Surveillance System Yearly Reports 2011–2013. Turkish Public Health Insititution. Available at http://uamdss.thsk.gov.tr, USA: Resistance Map-The Center for Disease Dynamics Economics & Policy (CDDEP) . Available at: http://resistancemap.cddep.org.