Current viewpoint on the epidemiology of nonfermenting Gram-negative bacterial strains

Curr Opin Infect Dis. 2023 Dec 1;36(6):545-554. doi: 10.1097/QCO.0000000000000977. Epub 2023 Sep 26.

Abstract

Purpose of review: This article aims to review the epidemiology of nonfermenting Gram-negative bacilli (NFGNB) based on recent literature reports, particularly, of the less common, but with emerging clinical significance species.

Recent findings: The reported frequency of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa is increasing, with very significant variability, however, between different countries. Apart from the major NFGNB, that is, A. baumannii and P. aeruginosa, already recognized as of critical importance healthcare risks, several other NFGNB genera have been increasingly associated with diverse severe infections, such as Stenotrophomonas maltophilia, Burkholderia spp., Elizabethkingia spp., Chryseobacterium spp., Achromobacter spp., Alcaligenes spp., Sphingomonas spp., Shewanella spp. and Ralstonia spp., among others.

Summary: The exploration of the epidemiology, as well as the pathogenic potential of the of the less frequent, but emerging and increasingly reported NFGNB, is crucial, not only for immunocompromised patients, but also for critically ill patients without overt immunosuppression. As we are heading fast towards a postantibiotic era, such information would contribute to the optimal antimicrobial management, that is, providing prompt, appropriate antimicrobial coverage when needed and, at the same time, avoiding overuse and/or inappropriate use of antimicrobial therapy. Also, it would help to better understand their transmission dynamics and to develop effective prevention strategies.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Gram-Negative Bacteria
  • Gram-Negative Bacterial Infections* / epidemiology
  • Gram-Negative Bacterial Infections* / microbiology
  • Humans
  • Immunocompromised Host
  • Microbial Sensitivity Tests
  • Pseudomonas aeruginosa

Substances

  • Anti-Bacterial Agents