Hard to treat multi-resistant gram negative bacteremia
First line antibiotics for gram negative bacteremia were defined as simultaneous to all carbapenems, all other beta lactams and all fluoroquinolones. In a sample including 173 American hospitals and 45,011 patients with gram negative bacteremia, a total of 471 (1%) had what the authors called difficult-to-treat resistance in gram negative bacteremia; 79 % of those patients received parentheral aminoglicosides, polymixin B or tigeciline. Mortality among them was 43.3 % higher than in simple carbapenem resistance. This difficult- to-treat gram negative bacteremia has clear implication for survival of such patients.
Kadri SS, Adjemian J, Lai YL, Spaulding AB, Ricotta E, Prevots DR, Palmore TN, Rhee C, Klompas M, Dekker JP, Powers JH 3rd, Suffredini AF, Hooper DC, Fridkin S, Danner RL; National Institutes of Health Antimicrobial Resistance Outcomes Research Initiative (NIH–ARORI). Difficult-to-treat resistance in gram-negative bacteremia at 173 US hospitals: retrospective cohort analysis of prevalence, predictors, and outcome of resistance to all first-line agents. Clin Infect Dis. 2018;67(12):1803-814. doi:10.1093/cid/ciy378.