The role of the microbiology laboratory in the diagnosis of multidrug-resistant Gram-negative bacilli infections. The importance of the determination of resistance mechanisms

Med Intensiva (Engl Ed). 2022 Aug;46(8):455-464. doi: 10.1016/j.medine.2022.05.003. Epub 2022 May 25.

Abstract

Early diagnosis and treatment has an important impact on the morbidity and mortality of infections caused by multidrug-resistant bacteria. Multidrug-resistant gram-negative bacilli (MR-GNB) constitute the main current threat in hospitals and especially in intensive care units (ICU). The role of the microbiology laboratory is essential in providing a rapid and effective response. This review updates the microbiology laboratory procedures for the rapid detection of BGN-MR and its resistance determinants. The role of the laboratory in the surveillance and control of outbreaks caused by these bacteria, including typing techniques, is also studied. The importance of providing standardized resistance maps that allow knowing the epidemiological situation of the different units is emphasized. Finally, the importance of effective communication systems for the transmission of results and decision making in the management of patients infected by BGN-MR is reviewed.

Keywords: Bacilos gramnegativos multirresistentes; Infecciones; Infections; Laboratorio de microbiología; Mecanismos de resistencia; Microbiology laboratory; Multidrug-resistant gram-negative bacilli; Resistance mechanisms.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Drug Resistance, Multiple, Bacterial
  • Gram-Negative Bacteria
  • Gram-Negative Bacterial Infections* / diagnosis
  • Gram-Negative Bacterial Infections* / drug therapy
  • Gram-Negative Bacterial Infections* / epidemiology
  • Humans
  • Intensive Care Units

Substances

  • Anti-Bacterial Agents