Oral Health Group

The Increasing Threat of Multidrug-Resistant Gram-Negative Infections


December 2, 2010
by ken

Luke F. Chen, MBBS, MPH, CIC, FRACP: Hello.
My name is Luke Chen. I’m from the Division of Infectious Diseases and
International Health at Duke University [Durham, North Carolina]. Today
we are talking about the evolving epidemiology and increasing threat of
gram-negative infections, particularly multidrug-resistant gram-negative
infections. With me is Dr. Matthew Falagas,Director of the Alfa
Institute of Biomedical Sciences in Athens,Greece, and Adjunct
Associate Professor of Medicine at Tufts University School of Medicine
in Boston, Massachusetts. Thank you for joining us, Dr. Falagas.

Portrait of Robert Koch (1843--1910).

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Matthew E. Falagas, MD, MSc, DSc: Thank you for the invitation, Dr. Chen.

Dr. Chen: We have been hearing and
talking a lot about multidrug-resistant gram-negative pathogens. Is
there any way that you can help us understand the difference between the
terminologies, such as “multidrug-resistant gram-negative” and
“pan-resistant gram-negative”?

Dr. Falagas: There is tremendous
diversity in the definitions of gram-negative bacilli with respect to
their resistance patterns. People frequently confuse the terms
“multidrug-resistant” (MDR), “extensively drug-resistant” (XDR), and
“pan-drug resistant” (PDR) gram-negative bacilli infections. An expert
committee that was initiated by the European Centre for Disease
Prevention and Control
(ECDC), with experts from the US Centers for
Disease Control and Prevention (CDC)
and other professional and
international organizations, held several meetings to resolve this
issue. It is important for clinicians and researchers to understand the
terminology and the definitions. In some countries, for example,
pathogens are called “pan-drug resistant,” which means resistant to all
available antimicrobial agents, despite the fact that there are therapeutic options.

Dr. Chen: These differences are obviously important to understand. Could clinicians look at their laboratory reports to understand them?

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