How Should We Treat HAP/VAP Caused by Carbapenemase-Producing Enterobacteriaceae?

Semin Respir Crit Care Med. 2017 Jun;38(3):301-310. doi: 10.1055/s-0037-1602656. Epub 2017 Jun 4.

Abstract

Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) represent a common problem in hospital setting worldwide. Infections caused by carbapenem-resistant Enterobacteriaceae (CRE) are an emergent problem due to the lack of therapeutic options available, leading to significant increases in morbidity and mortality. CRE have frequently been reported both in HAP/VAP, but limited data regarding the optimal treatment strategy in this setting are available. This review focuses on the current epidemiology of CRE, with a specific focus on HAP/VAP. Moreover, we will suggest a possible strategy for the empiric and targeted treatment of HAP and VAP in which the involvement of CRE is suspected or is confirmed.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Bacteriological Techniques
  • Carbapenem-Resistant Enterobacteriaceae
  • Carbapenems / therapeutic use
  • Cross Infection / drug therapy
  • Cross Infection / microbiology
  • Drug Administration Schedule
  • Drug Resistance, Multiple, Bacterial
  • Drug Therapy, Combination
  • Enterobacteriaceae Infections / drug therapy*
  • Enterobacteriaceae Infections / epidemiology*
  • Humans
  • Klebsiella Infections / epidemiology
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / drug effects
  • Nebulizers and Vaporizers
  • Pneumonia / drug therapy
  • Pneumonia / microbiology
  • Pneumonia, Ventilator-Associated / drug therapy*
  • Pneumonia, Ventilator-Associated / microbiology
  • Renal Insufficiency / epidemiology
  • Risk Factors

Substances

  • Anti-Bacterial Agents
  • Carbapenems