Frontiers in Public Health (Mar 2024)

Carbapenem-resistant Gram-negative bacteria (CR-GNB) in ICUs: resistance genes, therapeutics, and prevention – a comprehensive review

  • Qi Li,
  • Qi Li,
  • Xiaoshi Zhou,
  • Xiaoshi Zhou,
  • Rou Yang,
  • Rou Yang,
  • Xiaoyan Shen,
  • Xiaoyan Shen,
  • Guolin Li,
  • Guolin Li,
  • Changji Zhang,
  • Changji Zhang,
  • Pengfei Li,
  • Shiran Li,
  • Shiran Li,
  • Jingxian Xie,
  • Yong Yang,
  • Yong Yang

DOI
https://doi.org/10.3389/fpubh.2024.1376513
Journal volume & issue
Vol. 12

Abstract

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Intensive care units (ICUs) are specialized environments dedicated to the management of critically ill patients, who are particularly susceptible to drug-resistant bacteria. Among these, carbapenem-resistant Gram-negative bacteria (CR-GNB) pose a significant threat endangering the lives of ICU patients. Carbapenemase production is a key resistance mechanism in CR-GNB, with the transfer of resistance genes contributing to the extensive emergence of antimicrobial resistance (AMR). CR-GNB infections are widespread in ICUs, highlighting an urgent need for prevention and control measures to reduce mortality rates associated with CR-GNB transmission or infection. This review provides an overview of key aspects surrounding CR-GNB within ICUs. We examine the mechanisms of bacterial drug resistance, the resistance genes that frequently occur with CR-GNB infections in ICU, and the therapeutic options against carbapenemase genotypes. Additionally, we highlight crucial preventive measures to impede the transmission and spread of CR-GNB within ICUs, along with reviewing the advances made in the field of clinical predictive modeling research, which hold excellent potential for practical application.

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