Management of antibiotic resistance in the intensive care unit setting from an international perspective

Infections represent one of the most threatening complications for intensive care unit (ICU) patients. Approximately 50% of all ICU patients are treated for infection or suspected infection during their ICU stay, of which approximately half are acquired during the ICU stay. Multidrug-resistant (MDR) organisms are often the etiologic agents with a dramatic impact in morbidity and mortality rates. The emergence of carbapenemase-producing bacteria, in particular the emerging K. pneumoniae strains harboring the plasmid-encoded KPC-type carbapenemase and the New Delhi metallo-beta-lactamase 1 (NDM-1), in many countries is an example of the continuous evolution and spread of bacterial resistance. Infection prevention and control and antimicrobial stewardship programs in the ICU setting are demonstrating good results and need continuous implementation.