Antimicrobial resistance in nephrology

The prevalence of antimicrobial resistance among many common bacterial pathogens is increasing. The emergence and global dissemination of these antibiotic-resistant bacteria (ARB) is fuelled by antibiotic selection pressure, inter-organism transmission of resistance determinants, suboptimal infectio...

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Bibliographic Details
Published in:Nature reviews. Nephrology 2019-08, Vol.15 (8), p.463-481
Main Authors: Wang, Tina Z, Kodiyanplakkal, Rosy Priya L, Calfee, David P
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Antibiotics
Antimicrobial agents
Bacteria
Bacterial Infections - complications
Bacterial Infections - drug therapy
Bacterial Infections - microbiology
Disease prevention
Distribution
Drug resistance
Drug resistance in microorganisms
Drug Resistance, Bacterial
Drug therapy
Forecasts and trends
Humans
Kidney diseases
Kidney Diseases - complications
Kidney Diseases - microbiology
Methods
Mortality
Nephrology
Prevalence studies (Epidemiology)
Prevention
Staphylococcus infections
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Summary:The prevalence of antimicrobial resistance among many common bacterial pathogens is increasing. The emergence and global dissemination of these antibiotic-resistant bacteria (ARB) is fuelled by antibiotic selection pressure, inter-organism transmission of resistance determinants, suboptimal infection prevention practices and increasing ease and frequency of international travel, among other factors. Patients with chronic kidney disease, particularly those with end-stage renal disease who require dialysis and/or kidney transplantation, have some of the highest rates of colonization and infection with ARB worldwide. These ARB include methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus spp. and several multidrug-resistant Gram-negative organisms. Antimicrobial resistance limits treatment options and increases the risk of infection-related morbidity and mortality. Several new antibiotic agents with activity against some of the most common ARB have been developed, but resistance to these agents is already emerging and highlights the dire need for new treatment options as well as consistent implementation and improvement of basic infection prevention practices. Clinicians involved in the care of patients with renal disease must be familiar with the local epidemiology of ARB, remain vigilant for the emergence of novel resistance patterns and adhere strictly to practices proven to prevent transmission of ARB and other pathogens.
ISSN:1759-5061
1759-507X
DOI:10.1038/s41581-019-0150-7