Infection prevention measures to control multi-drug-resistant Gram-negative Infections

Gram-negative bacteria can cause serious infections including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis in healthcare settings.

Some Gram-negative bacteria have become resistant to most available antibiotics, causing infections for which we are running out of treatment options worldwide.

As you have learned in this course, these bacteria have built-in mechanisms to be resistant to our antibiotics and can pass along genetic materials that allow other bacteria to also become antibiotic-resistant. It is extremely important that we become antibiotic stewards: everyone playing a role in protecting the effectiveness of antibiotics by using them only when indicated, in the right dose, right frequency and right duration to treat bacterial infections.

There are some very useful blogs and websites to help with prescribing antibiotics some of which are listed in “see also” below.

Our global efforts must include preventive measures to avoid the spread of gram-negatives and the transmission of antibiotic resistance between patients.

The Centers for Disease Control and Prevention has been implementing efforts that include:

1. Outbreak investigations.
2. Surveillance of antibiotic resistance.
3. Rapid identification of resistant bacteria and cohorting/contact isolation of patients when possible when entering your healthcare facility.
4. Collaborations between healthcare facilities and health departments to identify isolates with unusual resistance and to determine new mechanisms of resistance among multidrug-resistant Gram-negatives, including the recent identification of a new mechanism of resistance in patients returning from continents such as Asia.

For more information visit the CDC website.

The United Kingdom Guidelines are an excellent resource to also implement activities to prevent the spread of Multi-drug Resistant Gram-negative bacteria. The current guidelines are available in “downloads” below. A video presentation, “UK Guidelines for GNB Infections” delivered by Professor Peter Hawkey, PHE Lead Public Health Microbiologist, Heart of England NHS Foundation Trust, Birmingham UK, discusses GNB infections and the guidelines for treatment.

You may also like to watch this video presentation “Prevention of Gram-negative infections” delivered by Professor Peter Wilson, Consultant Microbiologist, UCHL Foundation NHS Trust, London, to the BSAC Spring Conference 2017 in which he discusses the infection prevention measures required to prevent the spread of these infections.