Multiresistente Erreger

 

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Zusammenfassung

Infektionen, die durch multiresistente Erreger hervorgerufen werden, stellen ein zunehmendes Problem im medizinischen Alltag dar und gehen mit einer verlängerten Behandlungsdauer und einer erhöhten Mortalität einher. In den zurückliegenden Jahrzehnten lag das Hauptaugenmerk im Bereich multiresistenter Erreger auf dem bekanntesten Vertreter, dem Methicillin-resistenten Staphylococcus aureus (MRSA). In letzter Zeit haben jedoch resistente Gram-negative Erreger mit β-Laktamasen mit breitem Wirkspektrum (ESBL) und multiresistente Gram-negative Erreger (MRGN) zunehmend an Bedeutung gewonnen und stellen heute den Kliniker vor eine größere therapeutische Herausforderung als MRSA. Die vorliegende Arbeit gibt eine Übersicht über die Entstehung von Antibiotikaresistenz, die wichtigsten Erreger aus dem Gram-negativen und -positiven Keimspektrum, Clostridium difficile sowie Maßnahmen, um die Selektion resistenter Erreger zu reduzieren und deren Weiterverbreitung zu unterbinden.

Abstract

Infections caused by multidrug resistant (MDR) organisms are becoming more frequently in daily practice and are associated with an increase in duration of treatment and mortality. During the past decades, particular attention in the field of MDR pathogens was paid to methicillin-resistant staphylococcus aureus (MRSA). For the last years, MDR gram-negative organisms, with e.g., “extended-spectrum beta-lactamases” (ESBL), have been gaining a growing significance. Currently, treatment of infections with these organisms displays a greater challenge for the clinician compared to MRSA infections. This review illustrates the emergence of antibiotic resistance, provides information on the most important gram-negative and gram-positive bacteria, Clostridium difficile and measures to prevent their further spread.

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