Hristea Adriana 1, 2, Olaru Ioana Diana 1, Niculescu Iulia 1, Arama Victoria 1, 2, Jipa Raluca 1
1 “Prof. Dr. Matei Bals” National Institute for Infectious Diseases
2 “Carol Davila” University of Medicine and Pharmacy
Abstract
Resistant Gram negative bacilli have become a major concern. They are associated with increased mortality, prolonged hospitalization and increased costs. Carbapenem-resistant Pseudomonas aeruginosa, Acinetobacter baumanii, extended spectrum beta-lactamase-producing Enterobacteriaceae have become increasingly common. A dramatic increase of CTX-M enzymes over TEM and SHV variants has recently occurred in Europe. There are considerable differences in beta-lactamase distribution between geographical areas as well as depending on the setting of infection. CTX-M type enzyme is considered to play an important role in community-acquired infections. Globalization and travel provide opportunities for the spread of resistant organisms responsible for infections that occur in hospitals as well as in community. Infections with carbapenem-resistant Enterobacteriaceae (CRE) are emerging as an important challenge in health-care settings. The potential widespread of carbapenem resistance via plasmids can lead to the spread of CRE into the community as well. Molecular epidemiology has proven very useful in detecting specific antimicrobial drug-resistance genes in a large number of organisms; it plays a key role in distinguishing between a pathogenic strain and a commensal contaminant, as well as between a relapse and a reinfection. Molecular biology typing techniques combined with epidemiological investigations also provide information about nosocomial pathogens and can be very useful for the implementation of effective infection control measures within the hospital environment. A comprehensive infection control program requires a sustained collaboration between infection control departments, clinical microbiology laboratories and hospital epidemiologist. Early detection of nosocomial drug-resistant pathogens through identification of pathogen clonality allows rapid intervention, which ensure the control of nosocomial infections.