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. 2017 Apr 10:12:Doc05.
doi: 10.3205/dgkh000290. eCollection 2017.

Antibiotic resistance: What is so special about multidrug-resistant Gram-negative bacteria?

Martin Exner  1 , Sanjay Bhattacharya  2 , Bärbel Christiansen  3 , Jürgen Gebel  1 , Peter Goroncy-Bermes  4 , Philippe Hartemann  5 , Peter Heeg  6 , Carola Ilschner  1 , Axel Kramer  7 , Elaine Larson  8   9 , Wolfgang Merkens  4 , Martin Mielke  10 , Peter Oltmanns  4 , Birgit Ross  11 , Manfred Rotter  12 , Ricarda Maria Schmithausen  1 , Hans-Günther Sonntag  13 , Matthias Trautmann  14
Affiliations

Antibiotic resistance: What is so special about multidrug-resistant Gram-negative bacteria?

Martin Exner et al. GMS Hyg Infect Control. .

Abstract
in English, German

In the past years infections caused by multidrug-resistant Gram-negative bacteria have dramatically increased in all parts of the world. This consensus paper is based on presentations, subsequent discussions and an appraisal of current literature by a panel of international experts invited by the Rudolf Schülke Stiftung, Hamburg. It deals with the epidemiology and the inherent properties of Gram-negative bacteria, elucidating the patterns of the spread of antibiotic resistance, highlighting reservoirs as well as transmission pathways and risk factors for infection, mortality, treatment and prevention options as well as the consequences of their prevalence in livestock. Following a global, One Health approach and based on the evaluation of the existing knowledge about these pathogens, this paper gives recommendations for prevention and infection control measures as well as proposals for various target groups to tackle the threats posed by Gram-negative bacteria and prevent the spread and emergence of new antibiotic resistances.

In den letzten Jahren haben die durch multiresistente Gram-negative Bakterien (MRGN) verursachten Infektionen in allen Teilen der Welt dramatisch zugenommen. Der vorliegende Konsensus basiert auf Vorträgen mit sich anschließenden Diskussionen und späterer Auswertung der einschlägigen Literatur durch ein internationales Expertengremium, das von der Rudolf Schülke Stiftung, Hamburg, zu dem Meeting nach Hamburg eingeladen worden war. Im Fokus standen die Epidemiologie und die besonderen Eigenschaften Gram-negativer Bakterien, die Ausbreitung der Antibiotikaresistenz, die Reservoire, Übertragungswege und Risikofaktoren für Infektionen, die Mortalität, die Therapie und die Möglichkeiten der Prävention einschließlich der Konsequenzen des Vorkommens in der industriellen Tierhaltung. Dem One Health Ansatz folgend und basierend auf der Bewertung des Wissensstandes zu diesen Erregern werden Empfehlungen zur Prävention und Bekämpfung sowie Vorschläge für verschiedene Zielgruppen unterbreitet, um der Bedrohung durch MRGN zu begegnen, ihre Ausbreitung zu verhindern und die Entstehung neuer Antibiotikaresistenzen zu unterbinden.

Keywords: agriculture; biocides; disinfection; epidemiology; infection control measures; multidrug-resistant Gram-negative bacteria; reservoirs; resistance patterns; surveillance; therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Table 1
Table 1. Examples for frequent natural reservoirs and sites of colonization, transmission paths and types of infection of selected Gram-negative bacteria
See this image and copyright information in PMC

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