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      Multidrug Resistant Gram-Negative Bacteria in Community-Acquired Pneumonia

      review-article
      Author(s): 1 , 2 , 3 , 4 , 5 , 1 , 2 , 3 , 4 ,
      Publication date (Electronic):
      Journal: Critical Care
      Publisher: BioMed Central

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          Abstract

          This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2019. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2019. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.

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          Most cited references38

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          BTS guidelines for the management of community acquired pneumonia in adults: update 2009.

          W Lim, S Baudouin, R C George … (2009)
          Article 0 comments Cited 424 times – based on 0 reviews     Review now
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            Antimicrobial Resistance of Hypervirulent Klebsiella pneumoniae : Epidemiology, Hypervirulence-Associated Determinants, and Resistance Mechanisms

            Chang-Ro Lee, Jung Lee, Kwang Park … (2017)
            Klebsiella pneumoniae is one of the most clinically relevant species in immunocompromised individuals responsible for community-acquired and nosocomial infections, including pneumonias, urinary tract infections, bacteremias, and liver abscesses. Since the mid-1980s, hypervirulent K. pneumoniae, generally associated with the hypermucoviscosity phenotype, has emerged as a clinically significant pathogen responsible for serious disseminated infections, such as pyogenic liver abscesses, osteomyelitis, and endophthalmitis, in a generally younger and healthier population. Hypervirulent K. pneumoniae infections were primarily found in East Asia and now are increasingly being reported worldwide. Although most hypervirulent K. pneumoniae isolates are antibiotic-susceptible, some isolates with combined virulence and resistance, such as the carbapenem-resistant hypervirulent K. pneumoniae isolates, are increasingly being detected. The combination of multidrug resistance and enhanced virulence has the potential to cause the next clinical crisis. To better understand the basic biology of hypervirulent K. pneumoniae, this review will provide a summarization and discussion focused on epidemiology, hypervirulence-associated factors, and antibiotic resistance mechanisms of such hypervirulent strains. Epidemiological analysis of recent clinical isolates in China warns the global dissemination of hypervirulent K. pneumoniae strains with extensive antibiotic resistance in the near future. Therefore, an immediate response to recognize the global dissemination of this hypervirulent strain with resistance determinants is an urgent priority.
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              Common infections in diabetes: pathogenesis, management and relationship to glycaemic control.

              James McCarthy, Anton Peleg, James S McCarthy … (2007)
              Specific defects in innate and adaptive immune function have been identified in diabetic patients in a range of in vitro studies. However, the relevance of these findings to the integrated response to infection in vivo remains unclear, especially in patients with good glycaemic control. Vaccine efficacy seems adequate in most diabetic patients, but those with type 1 diabetes and high glycosylated haemoglobin levels are most likely to exhibit hypo-responsiveness. While particular infections are closely associated with diabetes, this is usually in the context of extreme metabolic disturbances such as ketoacidosis. The link between glycaemic control and the risk of common community-acquired infections is less well established but could be clarified if infection data from large community-based observational or intervention studies were available. The relationship between hospital-acquired infections and diabetes is well recognized, particularly among post-operative cardiac and critically ill surgical patients in whom intensive insulin therapy improves clinical outcome independent of glycaemia. Nevertheless, further research is needed to improve our understanding of the role of diabetes and glycaemic control in the pathogenesis and management of community- and hospital-acquired infections.
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                Author and article information

                Contributors
                Antoni Torres: atorres@clinic.cat
                Journal
                Journal ID (nlm-ta): Crit Care
                Title: Critical Care
                Publisher: BioMed Central (London )
                ISSN (Print): 1364-8535
                ISSN (Electronic): 1466-609X
                Publication date (Electronic): 9 March 2019
                Publication date PMC-release: 9 March 2019
                Publication date Collection: 2019
                Volume: 23
                Electronic Location Identifier: 79
                Affiliations
                [1 ]ISNI 0000 0000 9635 9413, GRID grid.410458.c, Department of Pneumology, , Hospital Clinic of Barcelona, ; Barcelona, Spain
                [2 ]GRID grid.10403.36, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), ; Barcelona, Spain
                [3 ]ISNI 0000 0004 1937 0247, GRID grid.5841.8, University of Barcelona, ; Barcelona, Spain
                [4 ]Biomedical Research Networking Centres in Respiratory Diseases (CIBERES), Barcelona, Spain
                [5 ]ISNI 0000 0001 0941 3192, GRID grid.8142.f, Department of Anesthesiology and Intensive Care Medicine, , Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, ; Rome, Italy
                Article
                Publisher ID: 2371
                DOI: 10.1186/s13054-019-2371-3
                PMC ID: 6408800
                PubMed ID: 30850010
                SO-VID: 7fad1fe9-479b-4fac-ab93-ccb1327131ca
                Copyright © © Cillóniz et al. 2019
                History
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © The Author(s) 2019

                ScienceOpen disciplines: Emergency medicine & Trauma
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                ScienceOpen disciplines: Emergency medicine & Trauma

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