Combatting resistance: Understanding multi-drug resistant pathogens in intensive care units

Jianying Teng; Saber Imani; Aiping Zhou; Yuheng Zhao; Lailing Du; Shuli Deng; Jun Li; Qingjing Wang

doi:10.1016/j.biopha.2023.115564

Combatting resistance: Understanding multi-drug resistant pathogens in intensive care units

Biomed Pharmacother. 2023 Nov:167:115564. doi: 10.1016/j.biopha.2023.115564. Epub 2023 Sep 23.

Authors

Jianying Teng¹, Saber Imani², Aiping Zhou³, Yuheng Zhao⁴, Lailing Du², Shuli Deng⁵, Jun Li⁶, Qingjing Wang⁷

Affiliations

¹ Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang 310015, PR China; The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang 310000, PR China.
² Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang 310015, PR China.
³ Department of Laboratory Medicine, Shanghai East Hospital, School of Medicine, Tongji University, 1800 Yuntai Road, Shanghai, PR China.
⁴ College of Biology and Environmental Engineering, Zhejiang Shuren University, Hangzhou, Zhejiang 310015, PR China.
⁵ The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang 310000, PR China. Electronic address: dengshuli@zju.edu.cn.
⁶ College of Food Science and Engineering, Jiangxi Agricultural University, 1225 Zhimin Avenue, Nanchang, Jiangxi Province, PR China. Electronic address: lijunbioinfo@163.com.
⁷ Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang 310015, PR China. Electronic address: wangqj@zjsru.edu.cn.

PMID: 37748408
DOI: 10.1016/j.biopha.2023.115564

Abstract

The escalating misuse and excessive utilization of antibiotics have led to the widespread dissemination of drug-resistant bacteria, posing a significant global healthcare crisis. Of particular concern is the increasing prevalence of multi-drug resistant (MDR) opportunistic pathogens in Intensive Care Units (ICUs), which presents a severe threat to public health and contributes to substantial morbidity and mortality. Among them, MDR ESKAPE pathogens account for the vast majority of these opportunistic pathogens. This comprehensive review provides a meticulous analysis of the current prevalence landscape of MDR opportunistic pathogens in ICUs, especially in ESKAPE pathogens, illuminating their resistance mechanisms against commonly employed first-line antibiotics, including polymyxins, carbapenems, and tigecycline. Furthermore, this review explores innovative strategies aimed at preventing and controlling the emergence and spread of resistance. By emphasizing the urgent need for robust measures to combat nosocomial infections caused by MDR opportunistic pathogens in ICUs, this study serves as an invaluable reference for future investigations in the field of antibiotic resistance.

Keywords: ESKAPE pathogens; Multi-drug resistant opportunistic pathogens; Nosocomial infections; Prevalence situation; Resistance mechanisms; Therapeutic strategies.

Publication types

Review