Consequences of multidrug-resistant bacterial infections

Many people do not have a particularly good understanding of multidrug-resistant bacterial infections. The consequences of multidrug-resistant bacterial infections are relatively serious and pose a great threat to human health. The so-called multidrug-resistant bacteria refer to infections caused by multidrug-resistant pathogens, which are resistant to almost all antibiotics. This increases the difficulty of treatment and poses a great threat to the patient's life safety and physical health.

Consequences of multidrug-resistant bacterial infections

1. Hazards of multi-drug resistant bacteria

Multidrug-resistant bacterial infections have become a major reason for patients to prolong hospitalization and increase medical costs. Monitoring data show that the resistance rate of Staphylococcus aureus detected in the hospital to penicillin and cephalosporins is as high as 70%, and the resistance rate of Escherichia coli and Klebsiella pneumoniae to third-generation cephalosporins is over 50%. Experts say that prevention of multidrug-resistant bacterial infections should start with standardized medication and control of transmission.

The so-called multidrug-resistant bacteria refer to bacteria that are resistant to three or more types of antimicrobial drugs used clinically. The increase in multidrug-resistant bacteria pollutes the hospital environment and ultimately endangers medical safety. To prevent multidrug-resistant bacterial infections, we must first strengthen the rational use of antibiotics, such as standardizing preventive medication during surgery and limiting the use of antibiotics to less than 48 hours. Secondly, multidrug-resistant bacterial infections are mainly transmitted through contact. Medical staff should pay attention to hand hygiene and environmental cleaning and disinfection, reduce the sharing of equipment between patients, and reduce the chance of cross-infection.

3. Resistance mechanism of multidrug-resistant bacteria

Multidrug resistance (MDR) refers to the resistance to multiple commonly used antimicrobial drugs at the same time. The main mechanism is the mutation of efflux membrane pump genes, followed by changes in outer membrane permeability and the production of ultra-broad-spectrum enzymes. The most common Gram-positive bacteria are MDR-TB and MDR-MRSA, as well as Acinetobacter baumannii and Pseudomonas aeruginosa, which often appear in the ICU and are only sensitive to penicillins; Stenotrophomonas maltophilia is resistant to almost all antibiotics except co-trimoxazole. The emergence of MDR has determined the necessity of combined drug use; the high frequency of MDR strains means that the era of antimicrobial drugs is coming to an end.

Predictors of infection with multidrug-resistant bacteria

To help physicians distinguish patients with resistant pathogens from those without, the following prediction rules can be reviewed. Prediction criterion 1: Nursing-related Gram-negative rod-shaped infections are often caused by drug-resistant Enterobacteriaceae. Unless invasive procedures have been performed, it is unlikely that non-fermenting bacteria will cause the infection. The use of fluoroquinolones is closely associated with the development of fluoroquinolone resistance.

Prediction criterion 2: Infection after use of a certain antibiotic indicates the possibility of resistance to this drug and an increased likelihood of resistance to all co-selected agents.

Multidrug resistance (MDR) co-selection means resistance to penicillins, cephalosporins, aminoglycosides, sulfaquinoxals or quinolones.

Given these predictive criteria, a risk stratification system for the development of resistant pathogens was developed by evaluating the degree of contact between patients and health care facilities, previous history of antibiotic treatment, and patient characteristics.