Original Publication Date: 13 February, 2017
Publication / Source: Infectious Diseases Hub
Authors: Patrice Nordmann & Laurent Poirel (University of Fribourg, Switzerland)
Rapid diagnostic tests for detecting emerging antibiotic resistance are mostly available and should be used now.
Clinically-significant multidrug-resistant bacteria are increasingly reported within enterobacterial species (e.g., Escherichia coli, Klebsiella pneumoniae, Enterobacter spp) and also within the two nosocomial Gram-negative pathogens, namely Pseudomonas aeruginosa and Acinetobacter baumannii [1].
The antibiotic resistance traits that are currently widespread in these Gram-negatives are mostly extended-spectrum ß-lactamases (ESBL) and carbapanemases producers [2, 3]. The ESBLs confer resistance to all b-lactams, with the exception of cephamycins and carbapenems, while carbapenemases confer resistance to virtually all b-lactams including carbapenems [2, 3]. In addition, ESBL and carbapenemase-producers are often resistant to non-related broad-spectrum antibiotics such as aminoglycosides and fluoroquinolones. Among the latest emerging antibiotic resistance traits, polymyxin resistance and pandrug resistance to aminoglycosides are also of concern [4, 5].
Historically, diagnosis and evaluation of antimicrobial resistance has been based on the culture of microorganisms. This ‘old-fashioned’ way of testing antibiotic susceptibility has proven to be quite accurate; however, it is time consuming, especially for slow-growing organisms (from 24 hour rapid-growth bacteria to several days), and it is neither adapted to adequate antibiotic stewardship nor to epidemiological purposes including the identification of the resistance mechanism(s).
