Advertisement

Multidrug-Resistant Bacteria: The Emerging Crisis

  • Daniel Livorsi
  • Edward Stenehjem
  • Robert Gaynes
Chapter
Part of the Emerging Infectious Diseases of the 21st Century book series (EIDC)

Abstract

Over the past 50 years, significant advances in drug development, surgical techniques, medical therapy, and device manufacturing have propelled the field of medicine to new heights. Organ transplantation is more common and successful than ever; patients with HIV are able to maintain stable immune function with one pill a day; critical care monitoring has never been so advanced; and chronic medical conditions are treated effectively with a wide variety of medical options. Managing complex patients like these would be nearly impossible without the use of effective antimicrobial therapy to treat inevitable infections. These advancements, however, are actively being threatened by an increase in multidrug-resistant organisms (MDROs). Without urgent action and increased education, MDROs have the potential to reverse decades of medical innovation.

Keywords

Antibiotic Resistance Active Surveillance Hand Hygiene Stewardship Program Vancomycin Resistance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Klevens RM, Edwards JR, Tenover FC, McDonald LC, Horan T, Gaynes R (2006) Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992–2003. Clin Infect Dis 42:389–391PubMedGoogle Scholar
  2. 2.
    Tracy LA, Furuno JP, Harris AD, Singer M, Langenberg P, Roghmann MC (2011) Staphylococcus aureus infections in US Veterans, Maryland, USA, 1999–2008. Emerg Infect Dis 17:441–448PubMedGoogle Scholar
  3. 3.
    Yigit H, Queenan AM, Anderson GJ, Domenech-Sanchez A, Biddle JW, Steward CD et al (2001) Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother 45:1151–1161. PMCID: 90438PubMedGoogle Scholar
  4. 4.
    Woodford N, Tierno PM Jr, Young K, Tysall L, Palepou MF, Ward E et al (2004) Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A beta-lactamase, KPC-3, in a New York Medical Center. Antimicrob Agents Chemother 48:4793–4799. PMCID: 529220PubMedGoogle Scholar
  5. 5.
    Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R et al (2010) Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis 10:597–602. PMCID: 2933358PubMedGoogle Scholar
  6. 6.
    Moellering RC Jr (2010) NDM-1—a cause for worldwide concern. N Engl J Med 363: 2377–2379PubMedGoogle Scholar
  7. 7.
    Anderson DJ, Kaye KS, Chen LF, Schmader KE, Choi Y, Sloane R et al (2009) Clinical and financial outcomes due to methicillin resistant Staphylococcus aureus surgical site infection: a multi-center matched outcomes study. PLoS One 4:e8305. PMCID: 2788700PubMedGoogle Scholar
  8. 8.
    Mauldin PD, Salgado CD, Hansen IS, Durup DT, Bosso JA (2010) Attributable hospital cost and length of stay associated with health care-associated infections caused by antibiotic-resistant gram-negative bacteria. Antimicrob Agents Chemother 54:109–115. PMCID: 2798544PubMedGoogle Scholar
  9. 9.
    Schwaber MJ, Navon-Venezia S, Kaye KS, Ben-Ami R, Schwartz D, Carmeli Y (2006) Clinical and economic impact of bacteremia with extended-spectrum-beta-lactamase-producing Enterobacteriaceae. Antimicrob Agents Chemother 50:1257–1262. PMCID: 1426954PubMedGoogle Scholar
  10. 10.
    Sostarich AM, Zolldann D, Haefner H, Luetticken R, Schulze-Roebecke R, Lemmen SW (2008) Impact of multiresistance of gram-negative bacteria in bloodstream infection on mortality rates and length of stay. Infection 36:31–35PubMedGoogle Scholar
  11. 11.
    Davis KA, Stewart JJ, Crouch HK, Florez CE, Hospenthal DR (2004) Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection. Clin Infect Dis 39:776–782PubMedGoogle Scholar
  12. 12.
    Boucher H, Miller LG, Razonable RR (2010) Serious infections caused by methicillin-resistant Staphylococcus aureus. Clin Infect Dis 51(Suppl 2):S183–S197PubMedGoogle Scholar
  13. 13.
    Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y (2003) Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis 36:53–59PubMedGoogle Scholar
  14. 14.
    Mekontso-Dessap A, Kirsch M, Brun-Buisson C, Loisance D (2001) Poststernotomy mediastinitis due to Staphylococcus aureus: comparison of methicillin-resistant and methicillin-susceptible cases. Clin Infect Dis 32:877–883PubMedGoogle Scholar
  15. 15.
    Engemann JJ, Carmeli Y, Cosgrove SE, Fowler VG, Bronstein MZ, Trivette SL et al (2003) Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis 36:592–598PubMedGoogle Scholar
  16. 16.
    DiazGranados CA, Zimmer SM, Klein M, Jernigan JA (2005) Comparison of mortality associated with vancomycin-resistant and vancomycin-susceptible enterococcal bloodstream infections: a meta-analysis. Clin Infect Dis 41:327–333PubMedGoogle Scholar
  17. 17.
    DiazGranados CA, Jernigan JA (2005) Impact of vancomycin resistance on mortality among patients with neutropenia and enterococcal bloodstream infection. J Infect Dis 191:588–595PubMedGoogle Scholar
  18. 18.
    Carmeli Y, Eliopoulos G, Mozaffari E, Samore M (2002) Health and economic outcomes of vancomycin-resistant enterococci. Arch Intern Med 162:2223–2228PubMedGoogle Scholar
  19. 19.
    Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB (2004) Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 39:309–317PubMedGoogle Scholar
  20. 20.
    Joseph NM, Sistla S, Dutta TK, Badhe AS, Parija SC (2010) Ventilator-associated pneumonia: a review. Eur J Intern Med 21:360–368PubMedGoogle Scholar
  21. 21.
    Metan G, Sariguzel F, Sumerkan B (2009) Factors influencing survival in patients with multi-drug-resistant Acinetobacter bacteraemia. Eur J Intern Med 20:540–544PubMedGoogle Scholar
  22. 22.
    Marchaim D, Gottesman T, Schwartz O, Korem M, Maor Y, Rahav G et al (2010) National multicenter study of predictors and outcomes of bacteremia upon hospital admission caused by Enterobacteriaceae producing extended-spectrum beta-lactamases. Antimicrob Agents Chemother 54:5099–5104. PMCID: 2981239PubMedGoogle Scholar
  23. 23.
    Cosgrove SE, Kaye KS, Eliopoulous GM, Carmeli Y (2002) Health and economic outcomes of the emergence of third-generation cephalosporin resistance in Enterobacter species. Arch Intern Med 162:185–190PubMedGoogle Scholar
  24. 24.
    Tumbarello M, Spanu T, Sanguinetti M, Citton R, Montuori E, Leone F et al (2006) Bloodstream infections caused by extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae: risk factors, molecular epidemiology, and clinical outcome. Antimicrob Agents Chemother 50:498–504. PMCID: 1366869PubMedGoogle Scholar
  25. 25.
    Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH (2000) The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest 118:146–155PubMedGoogle Scholar
  26. 26.
    Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S et al (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34:1589–1596PubMedGoogle Scholar
  27. 27.
    Shorr AF, Micek ST, Welch EC, Doherty JA, Reichley RM, Kollef MH (2011) Inappropriate antibiotic therapy in gram-negative sepsis increases hospital length of stay. Crit Care Med 39:46–51PubMedGoogle Scholar
  28. 28.
    Sipahi OR (2008) Economics of antibiotic resistance. Expert Rev Anti Infect Ther 6:523–539PubMedGoogle Scholar
  29. 29.
    Daxboeck F, Budic T, Assadian O, Reich M, Koller W (2006) Economic burden associated with multi-resistant gram-negative organisms compared with that for methicillin-resistant Staphylococcus aureus in a university teaching hospital. J Hosp Infect 62:214–218PubMedGoogle Scholar
  30. 30.
    Benveniste R, Davies J (1973) Aminoglycoside antibiotic-inactivating enzymes in actinomycetes similar to those present in clinical isolates of antibiotic-resistant bacteria. Proc Natl Acad Sci U S A 70:2276–2280. PMCID: 433717PubMedGoogle Scholar
  31. 31.
    Whitman WB, Coleman DC, Wiebe WJ (1998) Prokaryotes: the unseen majority. Proc Natl Acad Sci U S A 95:6578–6583. PMCID: 33863PubMedGoogle Scholar
  32. 32.
    Wright GD (2010) Antibiotic resistance in the environment: a link to the clinic? Curr Opin Microbiol 13:589–594PubMedGoogle Scholar
  33. 33.
    Wright GD (2007) The antibiotic resistome: the nexus of chemical and genetic diversity. Nat Rev Microbiol 5:175–186PubMedGoogle Scholar
  34. 34.
    D’Costa VM, McGrann KM, Hughes DW, Wright GD (2006) Sampling the antibiotic resistome. Science 311:374–377PubMedGoogle Scholar
  35. 35.
    Brown MG, Balkwill DL (2009) Antibiotic resistance in bacteria isolated from the deep terrestrial subsurface. Microb Ecol 57:484–493PubMedGoogle Scholar
  36. 36.
    Knapp CW, Dolfing J, Ehlert PA, Graham DW (2010) Evidence of increasing antibiotic resistance gene abundances in archived soils since 1940. Environ Sci Technol 44:580–587PubMedGoogle Scholar
  37. 37.
    Cattoir V, Poirel L, Aubert C, Soussy CJ, Nordmann P (2008) Unexpected occurrence of plasmid-mediated quinolone resistance determinants in environmental Aeromonas spp. Emerg Infect Dis 14:231–237. PMCID: 2600179PubMedGoogle Scholar
  38. 38.
    Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD (2010) Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ 340:c2096PubMedGoogle Scholar
  39. 39.
    Johnson L, Sabel A, Burman WJ, Everhart RM, Rome M, MacKenzie TD et al (2008) Emergence of fluoroquinolone resistance in outpatient urinary Escherichia coli isolates. Am J Med 121:876–884PubMedGoogle Scholar
  40. 40.
    Lepper PM, Grusa E, Reichl H, Hogel J, Trautmann M (2002) Consumption of imipenem correlates with beta-lactam resistance in Pseudomonas aeruginosa. Antimicrob Agents Chemother 46:2920–2925. PMCID: 127431PubMedGoogle Scholar
  41. 41.
    Carmeli Y, Troillet N, Eliopoulos GM, Samore MH (1999) Emergence of antibiotic-resistant Pseudomonas aeruginosa: comparison of risks associated with different antipseudomonal agents. Antimicrob Agents Chemother 43:1379–1382. PMCID: 89282PubMedGoogle Scholar
  42. 42.
    Troillet N, Samore MH, Carmeli Y (1997) Imipenem-resistant Pseudomonas aeruginosa: risk factors and antibiotic susceptibility patterns. Clin Infect Dis 25(5):1094–1098PubMedGoogle Scholar
  43. 43.
    Kritsotakis EI, Tsioutis C, Roumbelaki M, Christidou A, Gikas A (2011) Antibiotic use and the risk of carbapenem-resistant extended-spectrum-{beta}-lactamase-producing Klebsiella pneumoniae infection in hospitalized patients: results of a double case-control study. J Antimicrob Chemother 66(6):1383–1391PubMedGoogle Scholar
  44. 44.
    Paterson DL, Ko WC, Von Gottberg A, Mohapatra S, Casellas JM, Goossens H et al (2004) International prospective study of Klebsiella pneumoniae bacteremia: implications of extended-spectrum beta-lactamase production in nosocomial Infections. Ann Intern Med 140:26–32PubMedGoogle Scholar
  45. 45.
    Gregory CJ, Llata E, Stine N, Gould C, Santiago LM, Vazquez GJ et al (2010) Outbreak of carbapenem-resistant Klebsiella pneumoniae in Puerto Rico associated with a novel carbapenemase variant. Infect Control Hosp Epidemiol 31:476–484PubMedGoogle Scholar
  46. 46.
    Kochar S, Sheard T, Sharma R, Hui A, Tolentino E, Allen G et al (2009) Success of an infection control program to reduce the spread of carbapenem-resistant Klebsiella pneumoniae. Infect Control Hosp Epidemiol 30:447–452PubMedGoogle Scholar
  47. 47.
    Monnet DL, Archibald LK, Phillips L, Tenover FC, McGowan JE Jr, Gaynes RP (1998) Antimicrobial use and resistance in eight US hospitals: complexities of analysis and modeling. Intensive Care Antimicrobial Resistance Epidemiology Project and National Nosocomial Infections Surveillance System Hospitals. Infect Control Hosp Epidemiol 19:388–394PubMedGoogle Scholar
  48. 48.
    Jacoby GA, Medeiros AA (1991) More extended-spectrum beta-lactamases. Antimicrob Agents Chemother 35:1697–1704. PMCID: 245253PubMedGoogle Scholar
  49. 49.
    Chang S, Sievert DM, Hageman JC, Boulton ML, Tenover FC, Downes FP et al (2003) Infection with vancomycin-resistant Staphylococcus aureus containing the vanA resistance gene. N Engl J Med 348:1342–1347PubMedGoogle Scholar
  50. 50.
    Jacob G, Bush K (2011) ß-lactamase classification and amino acid sequences for TEM, SHV and OXA extended-spectrum and inhibitor resistant enzymes [updated 2011]. Available from www.lahey.org/Studies. Accessed 13 June 2011
  51. 51.
    Ambler RP (1980) The structure of beta-lactamases. Philos Trans R Soc Lond B Biol Sci 289:321–331PubMedGoogle Scholar
  52. 52.
    Bush K, Jacoby GA, Medeiros AA (1995) A functional classification scheme for beta-lactamases and its correlation with molecular structure. Antimicrob Agents Chemother 39:1211–1233. PMCID: 162717PubMedGoogle Scholar
  53. 53.
    Jacoby GA (2005) Mechanisms of resistance to quinolones. Clin Infect Dis 41(Suppl 2): S120–S126PubMedGoogle Scholar
  54. 54.
    Nannini E, Murray BE, Arias CA (2010) Resistance or decreased susceptibility to glycopeptides, daptomycin, and linezolid in methicillin-resistant Staphylococcus aureus. Curr Opin Pharmacol 10:516–521PubMedGoogle Scholar
  55. 55.
    Bonomo RA, Szabo D (2006) Mechanisms of multidrug resistance in Acinetobacter species and Pseudomonas aeruginosa. Clin Infect Dis 43(Suppl 2):S49–S56PubMedGoogle Scholar
  56. 56.
    Maragakis LL, Perl TM (2008) Acinetobacter baumannii: epidemiology, antimicrobial resistance, and treatment options. Clin Infect Dis 46:1254–1263PubMedGoogle Scholar
  57. 57.
    Li XZ, Nikaido H (2004) Efflux-mediated drug resistance in bacteria. Drugs 64:159–204PubMedGoogle Scholar
  58. 58.
    Leclercq R (2002) Mechanisms of resistance to macrolides and lincosamides: nature of the resistance elements and their clinical implications. Clin Infect Dis 34:482–492PubMedGoogle Scholar
  59. 59.
    Fournier PE, Vallenet D, Barbe V, Audic S, Ogata H, Poirel L et al (2006) Comparative genomics of multidrug resistance in Acinetobacter baumannii. PLoS Genet 2:e7. PMCID: 1326220PubMedGoogle Scholar
  60. 60.
    Peleg AY, Seifert H, Paterson DL (2008) Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 21:538–582. PMCID: 2493088PubMedGoogle Scholar
  61. 61.
    McGowan JE Jr (2006) Resistance in nonfermenting gram-negative bacteria: multidrug resistance to the maximum. Am J Med 119(6 Suppl 1):S29–S36; discussion S62-70PubMedGoogle Scholar
  62. 62.
    Hirsch EB, Tam VH (2010) Impact of multidrug-resistant Pseudomonas aeruginosa infection on patient outcomes. Expert Rev Pharmacoecon Outcomes Res 10:441–451PubMedGoogle Scholar
  63. 63.
    Zavascki AP, Carvalhaes CG, Picao RC, Gales AC (2010) Multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii: resistance mechanisms and implications for therapy. Expert Rev Anti Infect Ther 8:71–93PubMedGoogle Scholar
  64. 64.
    Shinefield HR, Ruff NL (2009) Staphylococcal infections: a historical perspective. Infect Dis Clin North Am 23:1–15PubMedGoogle Scholar
  65. 65.
    Kirby WM (1944) Extraction of a highly potent penicillin inactivator from penicillin resistant staphylococci. Science 99:452–453PubMedGoogle Scholar
  66. 66.
    Barber M, Rozwadowska-Dowzenko M (1948) Infection by penicillin-resistant staphylococci. Lancet 2:641–644PubMedGoogle Scholar
  67. 67.
    Jevons MP, Coe AW, Parker MT (1963) Methicillin resistance in staphylococci. Lancet 1:904–907PubMedGoogle Scholar
  68. 68.
    Berglund C, Soderquist B (2008) The origin of a methicillin-resistant Staphylococcus aureus isolate at a neonatal ward in Sweden—possible horizontal transfer of a staphylococcal cassette chromosome mec between methicillin-resistant Staphylococcus haemolyticus and Staphylococcus aureus. Clin Microbiol Infect 14:1048–1056PubMedGoogle Scholar
  69. 69.
    Archer GL, Niemeyer DM (1994) Origin and evolution of DNA associated with resistance to methicillin in staphylococci. Trends Microbiol 2:343–347PubMedGoogle Scholar
  70. 70.
    Wielders CL, Vriens MR, Brisse S, de Graaf-Miltenburg LA, Troelstra A, Fleer A et al (2001) In-vivo transfer of mecA DNA to Staphylococcus aureus [corrected]. Lancet 357:1674–1675PubMedGoogle Scholar
  71. 71.
    Barrett FF, McGehee RF Jr, Finland M (1968) Methicillin-resistant Staphylococcus aureus at Boston City Hospital. Bacteriologic and epidemiologic observations. N Engl J Med 279:441–448PubMedGoogle Scholar
  72. 72.
    O’Toole RD, Drew WL, Dahlgren BJ, Beaty HN (1970) An outbreak of methicillin-resistant Staphylococcus aureus infection. Observations in hospital and nursing home. JAMA 213:257–263PubMedGoogle Scholar
  73. 73.
    Chambers HF (2001) The changing epidemiology of Staphylococcus aureus? Emerg Infect Dis 7:178–182. PMCID: 2631711PubMedGoogle Scholar
  74. 74.
    Panlilio AL, Culver DH, Gaynes RP, Banerjee S, Henderson TS, Tolson JS et al (1992) Methicillin-resistant Staphylococcus aureus in U.S. hospitals, 1975–1991. Infect Control Hosp Epidemiol 13:582–586PubMedGoogle Scholar
  75. 75.
    Centers for Disease Control and Prevention (CDC) (1999) Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus—Minnesota and North Dakota, 1997–1999. MMWR Morb Mortal Wkly Rep 48:707–710Google Scholar
  76. 76.
    Klein E, Smith DL, Laxminarayan R (2009) Community-associated methicillin-resistant Staphylococcus aureus in outpatients, United States, 1999–2006. Emerg Infect Dis 15:1925–1930. PMCID: 3044510PubMedGoogle Scholar
  77. 77.
    Stranden AM, Frei R, Adler H, Fluckiger U, Widmer AF (2009) Emergence of SCCmec type IV as the most common type of methicillin-resistant Staphylococcus aureus in a university hospital. Infection 37:44–48PubMedGoogle Scholar
  78. 78.
    Liu C, Chambers HF (2003) Staphylococcus aureus with heterogeneous resistance to vancomycin: epidemiology, clinical significance, and critical assessment of diagnostic methods. Antimicrob Agents Chemother 47:3040–3045. PMCID: 201119PubMedGoogle Scholar
  79. 79.
    Howden BP, Davies JK, Johnson PD, Stinear TP, Grayson ML (2010) Reduced vancomycin susceptibility in Staphylococcus aureus, including vancomycin-intermediate and heterogeneous vancomycin-intermediate strains: resistance mechanisms, laboratory detection, and clinical implications. Clin Microbiol Rev 23:99–139. PMCID: 2806658PubMedGoogle Scholar
  80. 80.
    Satola SW, Lessa FC, Ray SM, Bulens SN, Lynfield R, Schaffner W et al (2011) Clinical and laboratory characteristics of invasive infections due to methicillin-resistant Staphylococcus aureus isolates demonstrating a vancomycin MIC of 2 micrograms per milliliter: lack of effect of heteroresistant vancomycin-intermediate S. aureus phenotype. J Clin Microbiol 49:1583–1587PubMedGoogle Scholar
  81. 81.
    Centers for Disease Control and Prevention (CDC) (2002) Staphylococcus aureus resistant to vancomycin—United States, 2002. MMWR Morb Mortal Wkly Rep 51:565–567Google Scholar
  82. 82.
    Sievert DM, Rudrik JT, Patel JB, McDonald LC, Wilkins MJ, Hageman JC (2008) Vancomycin-resistant Staphylococcus aureus in the United States, 2002–2006. Clin Infect Dis 46:668–674PubMedGoogle Scholar
  83. 83.
    Perichon B, Courvalin P (2009) VanA-type vancomycin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 53:4580–4587. PMCID: 2772335PubMedGoogle Scholar
  84. 84.
    Robbins WC, Tompsett R (1951) Treatment of enterococcal endocarditis and bacteremia; results of combined therapy with penicillin and streptomycin. Am J Med 10:278–299PubMedGoogle Scholar
  85. 85.
    Calderwood SA, Wennersten C, Moellering RC Jr, Kunz LJ, Krogstad DJ (1977) Resistance to six aminoglycosidic aminocyclitol antibiotics among enterococci: prevalence, evolution, and relationship to synergism with penicillin. Antimicrob Agents Chemother 12:401–405. PMCID: 429925PubMedGoogle Scholar
  86. 86.
    Zervos MJ, Kauffman CA, Therasse PM, Bergman AG, Mikesell TS, Schaberg DR (1987) Nosocomial infection by gentamicin-resistant Streptococcus faecalis. An epidemiologic study. Ann Intern Med 106:687–691PubMedGoogle Scholar
  87. 87.
    Leclercq R, Derlot E, Duval J, Courvalin P (1988) Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N Engl J Med 319:157–161PubMedGoogle Scholar
  88. 88.
    Uttley AH, Collins CH, Naidoo J, George RC (1988) Vancomycin-resistant enterococci. Lancet 1:57–58PubMedGoogle Scholar
  89. 89.
    National Nosocomial Infections Surveillance System (2004) National Nosocomial Infections Surveillance (NNIS) System report data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 32:470–485Google Scholar
  90. 90.
    Ramsey AM, Zilberberg MD (2009) Secular trends of hospitalization with vancomycin-resistant enterococcus infection in the United States, 2000–2006. Infect Control Hosp Epidemiol 30:184–186PubMedGoogle Scholar
  91. 91.
    Arias CA, Murray BE (2008) Emergence and management of drug-resistant enterococcal infections. Expert Rev Anti Infect Ther 6:637–655PubMedGoogle Scholar
  92. 92.
    Van der Auwera P, Pensart N, Korten V, Murray BE, Leclercq R (1996) Influence of oral glycopeptides on the fecal flora of human volunteers: selection of highly glycopeptide-resistant enterococci. J Infect Dis 173:1129–1136PubMedGoogle Scholar
  93. 93.
    Carmeli Y, Samore MH, Huskins C (1999) The association between antecedent vancomycin treatment and hospital-acquired vancomycin-resistant enterococci: a meta-analysis. Arch Intern Med 159:2461–2468PubMedGoogle Scholar
  94. 94.
    Fridkin SK, Edwards JR, Courval JM, Hill H, Tenover FC, Lawton R et al (2001) The effect of vancomycin and third-generation cephalosporins on prevalence of vancomycin-resistant enterococci in 126 U.S. adult intensive care units. Ann Intern Med 135:175–183PubMedGoogle Scholar
  95. 95.
    Bonten MJ, Willems R, Weinstein RA (2001) Vancomycin-resistant enterococci: why are they here, and where do they come from? Lancet Infect Dis 1:314–325PubMedGoogle Scholar
  96. 96.
    Gaynes R, Edwards JR (2005) Overview of nosocomial infections caused by gram-negative bacilli. Clin Infect Dis 41:848–854PubMedGoogle Scholar
  97. 97.
    Jacoby GA, Medeiros AA, O’Brien TF, Pinto ME, Jiang H (1988) Broad-spectrum, transmissible beta-lactamases. N Engl J Med 319:723–724PubMedGoogle Scholar
  98. 98.
    Monnet DL, Biddle JW, Edwards JR, Culver DH, Tolson JS, Martone WJ et al (1997) Evidence of interhospital transmission of extended-spectrum beta-lactam-resistant Klebsiella pneumoniae in the United States, 1986 to 1993. The National Nosocomial Infections Surveillance System. Infect Control Hosp Epidemiol 18:492–498PubMedGoogle Scholar
  99. 99.
    Nordmann P, Cuzon G, Naas T (2009) The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect Dis 9:228–236PubMedGoogle Scholar
  100. 100.
    Centers for Disease Control and Prevention (CDC) (2009) Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities. MMWR Morb Mortal Wkly Rep 58:256–260Google Scholar
  101. 101.
    Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K et al (2009) Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother 53:5046–5054. PMCID: 2786356PubMedGoogle Scholar
  102. 102.
    Nordmann P, Poirel L, Toleman MA, Walsh TR (2011) Does broad-spectrum {beta}-lactam resistance due to NDM-1 herald the end of the antibiotic era for treatment of infections caused by Gram-negative bacteria? J Antimicrob Chemother 66:689–692PubMedGoogle Scholar
  103. 103.
    Kallen AJ, Srinivasan A (2010) Current epidemiology of multidrug-resistant gram-negative bacilli in the United States. Infect Control Hosp Epidemiol 31(Suppl 1):S51–S54PubMedGoogle Scholar
  104. 104.
    Kallen AJ, Hidron AI, Patel J, Srinivasan A (2010) Multidrug resistance among gram-negative pathogens that caused healthcare-associated infections reported to the National Healthcare Safety Network, 2006–2008. Infect Control Hosp Epidemiol 31:528–531PubMedGoogle Scholar
  105. 105.
    Quale J, Bratu S, Landman D, Heddurshetti R (2003) Molecular epidemiology and mechanisms of carbapenem resistance in Acinetobacter baumannii endemic in New York City. Clin Infect Dis 37:214–220PubMedGoogle Scholar
  106. 106.
    Keen EF, Murray CK, Robinson BJ, Hospenthal DR, Co EM, Aldous WK (2010) Changes in the incidences of multidrug-resistant and extensively drug-resistant organisms isolated in a military medical center. Infect Control Hosp Epidemiol 31:728–732PubMedGoogle Scholar
  107. 107.
    Obritsch MD, Fish DN, MacLaren R, Jung R (2004) National surveillance of antimicrobial resistance in Pseudomonas aeruginosa isolates obtained from intensive care unit patients from 1993 to 2002. Antimicrob Agents Chemother 48:4606–4610. PMCID: 529178PubMedGoogle Scholar
  108. 108.
    Lin YC, Chen TL, Ju HL, Chen HS, Wang FD, Yu KW et al (2006) Clinical characteristics and risk factors for attributable mortality in Enterobacter cloacae bacteremia. J Microbiol Immunol Infect 39:67–72PubMedGoogle Scholar
  109. 109.
    Deshpande LM, Jones RN, Fritsche TR, Sader HS (2006) Occurrence and characterization of carbapenemase-producing Enterobacteriaceae: report from the SENTRY Antimicrobial Surveillance Program (2000–2004). Microb Drug Resist 12:223–230PubMedGoogle Scholar
  110. 110.
    Centers for Disease Control and Prevention (CDC) (2010) Detection of Enterobacteriaceae isolates carrying metallo-beta-lactamase – United States, 2010. MMWR Morb Mortal Wkly Rep 59:750Google Scholar
  111. 111.
    Bratu S, Landman D, Alam M, Tolentino E, Quale J (2005) Detection of KPC carbapenem-hydrolyzing enzymes in Enterobacter spp. from Brooklyn, New York. Antimicrob Agents Chemother 49:776–778. PMCID: 547228PubMedGoogle Scholar
  112. 112.
    Semmelweis IF, Carter KC (1983) The etiology, concept, and prophylaxis of childbed fever. University of Wisconsin Press, MadisonGoogle Scholar
  113. 113.
    Holmes OW (1974) Classic pages in obstetrics and gynecology. Oliver Wendell Holmes. The contagiousness of puerperal fever. The New England Quarterly Journal of Medicine and Surgery, vol. 1, pp. 503–530, 1842–1843. Am J Obstet Gynecol 119:852PubMedGoogle Scholar
  114. 114.
    Zachary KC, Bayne PS, Morrison VJ, Ford DS, Silver LC, Hooper DC (2001) Contamination of gowns, gloves, and stethoscopes with vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 22:560–564PubMedGoogle Scholar
  115. 115.
    Bonilla HF, Zervos MA, Lyons MJ, Bradley SF, Hedderwick SA, Ramsey MA et al (1997) Colonization with vancomycin-resistant Enterococcus faecium: comparison of a long-term-care unit with an acute-care hospital. Infect Control Hosp Epidemiol 18:333–339PubMedGoogle Scholar
  116. 116.
    Byers KE, Anglim AM, Anneski CJ, Germanson TP, Gold HS, Durbin LJ et al (2001) A hospital epidemic of vancomycin-resistant Enterococcus: risk factors and control. Infect Control Hosp Epidemiol 22:140–147PubMedGoogle Scholar
  117. 117.
    Bonten MJ, Slaughter S, Ambergen AW, Hayden MK, van Voorhis J, Nathan C et al (1998) The role of “colonization pressure” in the spread of vancomycin-resistant enterococci: an important infection control variable. Arch Intern Med 158:1127–1132PubMedGoogle Scholar
  118. 118.
    Boyce JM, Opal SM, Chow JW, Zervos MJ, Potter-Bynoe G, Sherman CB et al (1994) Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol 32:1148–1153. PMCID: 263627PubMedGoogle Scholar
  119. 119.
    Boyce JM, Potter-Bynoe G, Chenevert C, King T (1997) Environmental contamination due to methicillin-resistant Staphylococcus aureus: possible infection control implications. Infect Control Hosp Epidemiol 18:622–627PubMedGoogle Scholar
  120. 120.
    Larson EL, Early E, Cloonan P, Sugrue S, Parides M (2000) An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behav Med 26:14–22PubMedGoogle Scholar
  121. 121.
    Cromer AL, Latham SC, Bryant KG, Hutsell S, Gansauer L, Bendyk HA et al (2008) Monitoring and feedback of hand hygiene compliance and the impact on facility-acquired methicillin-resistant Staphylococcus aureus. Am J Infect Control 36:672–677PubMedGoogle Scholar
  122. 122.
    MacDonald A, Dinah F, MacKenzie D, Wilson A (2004) Performance feedback of hand hygiene, using alcohol gel as the skin decontaminant, reduces the number of inpatients newly affected by MRSA and antibiotic costs. J Hosp Infect 56:56–63PubMedGoogle Scholar
  123. 123.
    Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S et al (2000) Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet 356:1307–1312PubMedGoogle Scholar
  124. 124.
    Pittet D (2000) Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol 21:381–386PubMedGoogle Scholar
  125. 125.
    Olsen RJ, Lynch P, Coyle MB, Cummings J, Bokete T, Stamm WE (1993) Examination gloves as barriers to hand contamination in clinical practice. JAMA 270:350–353PubMedGoogle Scholar
  126. 126.
    Slaughter S, Hayden MK, Nathan C, Hu TC, Rice T, Van Voorhis J et al (1996) A comparison of the effect of universal use of gloves and gowns with that of glove use alone on acquisition of vancomycin-resistant enterococci in a medical intensive care unit. Ann Intern Med 125:448–456PubMedGoogle Scholar
  127. 127.
    Boyce JM, Mermel LA, Zervos MJ, Rice LB, Potter-Bynoe G, Giorgio C et al (1995) Controlling vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 16:634–637PubMedGoogle Scholar
  128. 128.
    Meyer KS, Urban C, Eagan JA, Berger BJ, Rahal JJ (1993) Nosocomial outbreak of Klebsiella infection resistant to late-generation cephalosporins. Ann Intern Med 119:353–358PubMedGoogle Scholar
  129. 129.
    Pena C, Pujol M, Ardanuy C, Ricart A, Pallares R, Linares J et al (1998) Epidemiology and successful control of a large outbreak due to Klebsiella pneumoniae producing extended-spectrum beta-lactamases. Antimicrob Agents Chemother 42:53–58. PMCID: 105455PubMedGoogle Scholar
  130. 130.
    Munoz-Price LS, Hayden MK, Lolans K, Won S, Calvert K, Lin M et al (2010) Successful control of an outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae at a long-term acute care hospital. Infect Control Hosp Epidemiol 31:341–347PubMedGoogle Scholar
  131. 131.
    Munoz-Price LS, De La Cuesta C, Adams S, Wyckoff M, Cleary T, McCurdy SP et al (2010) Successful eradication of a monoclonal strain of Klebsiella pneumoniae during a K. pneumoniae carbapenemase-producing K. pneumoniae outbreak in a surgical intensive care unit in Miami, Florida. Infect Control Hosp Epidemiol 31:1074–1077PubMedGoogle Scholar
  132. 132.
    Karageorgopoulos DE, Falagas ME (2008) Current control and treatment of multidrug-resistant Acinetobacter baumannii infections. Lancet Infect Dis 8:751–762PubMedGoogle Scholar
  133. 133.
    Ostrowsky BE, Trick WE, Sohn AH, Quirk SB, Holt S, Carson LA et al (2001) Control of vancomycin-resistant enterococcus in health care facilities in a region. N Engl J Med 344:1427–1433PubMedGoogle Scholar
  134. 134.
    Cooper BS, Stone SP, Kibbler CC, Cookson BD, Roberts JA, Medley GF et al (2004) Isolation measures in the hospital management of methicillin resistant Staphylococcus aureus (MRSA): systematic review of the literature. BMJ 329:533. PMCID: 516101PubMedGoogle Scholar
  135. 135.
    Muto CA, Jernigan JA, Ostrowsky BE, Richet HM, Jarvis WR, Boyce JM et al (2003) SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Infect Control Hosp Epidemiol 24:362–386PubMedGoogle Scholar
  136. 136.
    Stelfox HT, Bates DW, Redelmeier DA (2003) Safety of patients isolated for infection control. JAMA 290:1899–1905PubMedGoogle Scholar
  137. 137.
    Kirkland KB, Weinstein JM (1999) Adverse effects of contact isolation. Lancet 354:1177–1178PubMedGoogle Scholar
  138. 138.
    Evans HL, Shaffer MM, Hughes MG, Smith RL, Chong TW, Raymond DP et al (2003) Contact isolation in surgical patients: a barrier to care? Surgery 134:180–188PubMedGoogle Scholar
  139. 139.
    Saint S, Higgins LA, Nallamothu BK, Chenoweth C (2003) Do physicians examine patients in contact isolation less frequently? A brief report. Am J Infect Control 31:354–356PubMedGoogle Scholar
  140. 140.
    Boyce JM (2007) Environmental contamination makes an important contribution to hospital infection. J Hosp Infect 65(Suppl 2):50–54PubMedGoogle Scholar
  141. 141.
    Kramer A, Schwebke I, Kampf G (2006) How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect Dis 6:130. PMCID: 1564025PubMedGoogle Scholar
  142. 142.
    Boyce JM, Havill NL, Otter JA, Adams NM (2007) Widespread environmental contamination associated with patients with diarrhea and methicillin-resistant Staphylococcus aureus colonization of the gastrointestinal tract. Infect Control Hosp Epidemiol 28:1142–1147PubMedGoogle Scholar
  143. 143.
    Johnston CP, Cooper L, Ruby W, Carroll KC, Cosgrove SE, Perl TM (2006) Epidemiology of community-acquired methicillin-resistant Staphylococcus aureus skin infections among healthcare workers in an outpatient clinic. Infect Control Hosp Epidemiol 27:1133–1136PubMedGoogle Scholar
  144. 144.
    Grabsch EA, Burrell LJ, Padiglione A, O’Keeffe JM, Ballard S, Grayson ML (2006) Risk of environmental and healthcare worker contamination with vancomycin-resistant enterococci during outpatient procedures and hemodialysis. Infect Control Hosp Epidemiol 27:287–293PubMedGoogle Scholar
  145. 145.
    Bhalla A, Pultz NJ, Gries DM, Ray AJ, Eckstein EC, Aron DC et al (2004) Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalized patients. Infect Control Hosp Epidemiol 25:164–167PubMedGoogle Scholar
  146. 146.
    Ray AJ, Hoyen CK, Taub TF, Eckstein EC, Donskey CJ (2002) Nosocomial transmission of vancomycin-resistant enterococci from surfaces. JAMA 287:1400–1401PubMedGoogle Scholar
  147. 147.
    Tenorio AR, Badri SM, Sahgal NB, Hota B, Matushek M, Hayden MK et al (2001) Effectiveness of gloves in the prevention of hand carriage of vancomycin-resistant enterococcus species by health care workers after patient care. Clin Infect Dis 32:826–829PubMedGoogle Scholar
  148. 148.
    Duckro AN, Blom DW, Lyle EA, Weinstein RA, Hayden MK (2005) Transfer of vancomycin-resistant enterococci via health care worker hands. Arch Intern Med 165:302–307PubMedGoogle Scholar
  149. 149.
    Schultsz C, Meester HH, Kranenburg AM, Savelkoul PH, Boeijen-Donkers LE, Kaiser AM et al (2003) Ultra-sonic nebulizers as a potential source of methicillin-resistant Staphylococcus aureus causing an outbreak in a university tertiary care hospital. J Hosp Infect 55:269–275PubMedGoogle Scholar
  150. 150.
    Livornese LL Jr, Dias S, Samel C, Romanowski B, Taylor S, May P et al (1992) Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med 117:112–116PubMedGoogle Scholar
  151. 151.
    Bonten MJ, Hayden MK, Nathan C, van Voorhis J, Matushek M, Slaughter S et al (1996) Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet 348:1615–1619PubMedGoogle Scholar
  152. 152.
    Martinez JA, Ruthazer R, Hansjosten K, Barefoot L, Snydman DR (2003) Role of environmental contamination as a risk factor for acquisition of vancomycin-resistant enterococci in patients treated in a medical intensive care unit. Arch Intern Med 163:1905–1912PubMedGoogle Scholar
  153. 153.
    Hayden MK, Bonten MJ, Blom DW, Lyle EA, van de Vijver DA, Weinstein RA (2006) Reduction in acquisition of vancomycin-resistant enterococcus after enforcement of routine environmental cleaning measures. Clin Infect Dis 42:1552–1560PubMedGoogle Scholar
  154. 154.
    Rampling A, Wiseman S, Davis L, Hyett AP, Walbridge AN, Payne GC et al (2001) Evidence that hospital hygiene is important in the control of methicillin-resistant Staphylococcus aureus. J Hosp Infect 49:109–116PubMedGoogle Scholar
  155. 155.
    Sehulster L, Chinn RY (2003) Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 52:1–42PubMedGoogle Scholar
  156. 156.
    Simor AE, Lee M, Vearncombe M, Jones-Paul L, Barry C, Gomez M et al (2002) An outbreak due to multiresistant Acinetobacter baumannii in a burn unit: risk factors for acquisition and management. Infect Control Hosp Epidemiol 23:261–267PubMedGoogle Scholar
  157. 157.
    Denton M, Wilcox MH, Parnell P, Green D, Keer V, Hawkey PM et al (2004) Role of environmental cleaning in controlling an outbreak of Acinetobacter baumannii on a neurosurgical intensive care unit. J Hosp Infect 56:106–110PubMedGoogle Scholar
  158. 158.
    Mulin B, Rouget C, Clement C, Bailly P, Julliot MC, Viel JF et al (1997) Association of private isolation rooms with ventilator-associated Acinetobacter baumanii pneumonia in a surgical intensive-care unit. Infect Control Hosp Epidemiol 18:499–503PubMedGoogle Scholar
  159. 159.
    Perencevich EN, Fisman DN, Lipsitch M, Harris AD, Morris JG Jr, Smith DL (2004) Projected benefits of active surveillance for vancomycin-resistant enterococci in intensive care units. Clin Infect Dis 38:1108–1115PubMedGoogle Scholar
  160. 160.
    Chaix C, Durand-Zaleski I, Alberti C, Brun-Buisson C (1999) Control of endemic methicillin-resistant Staphylococcus aureus: a cost-benefit analysis in an intensive care unit. JAMA 282:1745–1751PubMedGoogle Scholar
  161. 161.
    Hachem R, Graviss L, Hanna H, Arbuckle R, Dvorak T, Hackett B et al (2004) Impact of surveillance for vancomycin-resistant enterococci on controlling a bloodstream outbreak among patients with hematologic malignancy. Infect Control Hosp Epidemiol 25:391–394PubMedGoogle Scholar
  162. 162.
    Chaberny IF, Schwab F, Ziesing S, Suerbaum S, Gastmeier P (2008) Impact of routine surgical ward and intensive care unit admission surveillance cultures on hospital-wide nosocomial methicillin-resistant Staphylococcus aureus infections in a university hospital: an interrupted time-series analysis. J Antimicrob Chemother 62:1422–1429PubMedGoogle Scholar
  163. 163.
    Huang SS, Yokoe DS, Hinrichsen VL, Spurchise LS, Datta R, Miroshnik I et al (2006) Impact of routine intensive care unit surveillance cultures and resultant barrier precautions on hospital-wide methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis 43:971–978PubMedGoogle Scholar
  164. 164.
    Ellingson K, Muder RR, Jain R, Kleinbaum D, Feng PJ, Cunningham C et al (2011) Sustained reduction in the clinical incidence of methicillin-resistant Staphylococcus aureus colonization or infection associated with a multifaceted infection control intervention. Infect Control Hosp Epidemiol 32:1–8PubMedGoogle Scholar
  165. 165.
    Robicsek A, Beaumont JL, Paule SM, Hacek DM, Thomson RB Jr, Kaul KL et al (2008) Universal surveillance for methicillin-resistant Staphylococcus aureus in 3 affiliated hospitals. Ann Intern Med 148:409–418PubMedGoogle Scholar
  166. 166.
    Muder RR, Cunningham C, McCray E, Squier C, Perreiah P, Jain R et al (2008) Implementation of an industrial systems-engineering approach to reduce the incidence of methicillin-resistant Staphylococcus aureus infection. Infect Control Hosp Epidemiol 29:702–708PubMedGoogle Scholar
  167. 167.
    Rodriguez-Bano J, Garcia L, Ramirez E, Lupion C, Muniain MA, Velasco C et al (2010) Long-term control of endemic hospital-wide methicillin-resistant Staphylococcus aureus (MRSA): the impact of targeted active surveillance for MRSA in patients and healthcare workers. Infect Control Hosp Epidemiol 31:786–795PubMedGoogle Scholar
  168. 168.
    Jain R, Kralovic SM, Evans ME, Ambrose M, Simbartl LA, Obrosky DS et al (2011) Veterans Affairs initiative to prevent methicillin-resistant Staphylococcus aureus infections. N Engl J Med 364:1419–1430PubMedGoogle Scholar
  169. 169.
    Kallen AJ, Mu Y, Bulens S, Reingold A, Petit S, Gershman K et al (2010) Health care-associated invasive MRSA infections, 2005–2008. JAMA 304:641–648PubMedGoogle Scholar
  170. 170.
    Coia JE, Duckworth GJ, Edwards DI, Farrington M, Fry C, Humphreys H et al (2006) Guidelines for the control and prevention of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect 63(Suppl 1):S1–S44PubMedGoogle Scholar
  171. 171.
    Carter A, Heffernan H, Holland D, Ikram R, Morris A, Roberts S et al (2002) Guidelines for the control of methicillin-resistant Staphylococcus aureus in New Zealand. New Zealand Ministry of Health. Available from http://www.moh.govt.nz/cd/mrsa. Accessed 13 June 2011
  172. 172.
    Harbarth S, Fankhauser C, Schrenzel J, Christenson J, Gervaz P, Bandiera-Clerc C et al (2008) Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA 299:1149–1157PubMedGoogle Scholar
  173. 173.
    Huskins WC, Huckabee CM, O’Grady NP, Murray P, Kopetskie H, Zimmer L et al (2011) Intervention to reduce transmission of resistant bacteria in intensive care. N Engl J Med 364:1407–1418PubMedGoogle Scholar
  174. 174.
    Harris AD, McGregor JC, Furuno JP (2006) What infection control interventions should be undertaken to control multidrug-resistant gram-negative bacteria? Clin Infect Dis 43(Suppl 2):S57–S61PubMedGoogle Scholar
  175. 175.
    Gardam MA, Burrows LL, Kus JV, Brunton J, Low DE, Conly JM et al (2002) Is surveillance for multidrug-resistant enterobacteriaceae an effective infection control strategy in the absence of an outbreak? J Infect Dis 186:1754–1760PubMedGoogle Scholar
  176. 176.
    Thouverez M, Talon D, Bertrand X (2004) Control of Enterobacteriaceae producing extended-spectrum beta-lactamase in intensive care units: rectal screening may not be needed in non-epidemic situations. Infect Control Hosp Epidemiol 25:838–841PubMedGoogle Scholar
  177. 177.
    Kola A, Holst M, Chaberny IF, Ziesing S, Suerbaum S, Gastmeier P (2007) Surveillance of extended-spectrum beta-lactamase-producing bacteria and routine use of contact isolation: experience from a three-year period. J Hosp Infect 66:46–51PubMedGoogle Scholar
  178. 178.
    Ben-David D, Maor Y, Keller N, Regev-Yochay G, Tal I, Shachar D et al (2010) Potential role of active surveillance in the control of a hospital-wide outbreak of carbapenem-resistant Klebsiella pneumoniae infection. Infect Control Hosp Epidemiol 31:620–626PubMedGoogle Scholar
  179. 179.
    Siegel JD RE, Jackson M, Chiarello L, The Healthcare Infection Control Practices Advisory Committee (2006) Management of multidrug-resistant organisms in healthcare settings [updated 2006]. Available from: http://www.cdc.gov/ncidod/dhqp/pdf/ar/MDROGuideline2006.pdf. Accessed 7 Feb 2011
  180. 180.
    Fazal BA, Telzak EE, Blum S, Turett GS, Petersen-Fitzpatrick FE, Lorian V (1996) Trends in the prevalence of methicillin-resistant Staphylococcus aureus associated with discontinuation of an isolation policy. Infect Control Hosp Epidemiol 17:372–374PubMedGoogle Scholar
  181. 181.
    Hartstein AI, LeMonte AM, Iwamoto PK (1997) DNA typing and control of methicillin-resistant Staphylococcus aureus at two affiliated hospitals. Infect Control Hosp Epidemiol 18:42–48PubMedGoogle Scholar
  182. 182.
    Brooks S, Khan A, Stoica D, Griffith J, Friedeman L, Mukherji R et al (1998) Reduction in vancomycin-resistant Enterococcus and Clostridium difficile infections following change to tympanic thermometers. Infect Control Hosp Epidemiol 19:333–336PubMedGoogle Scholar
  183. 183.
    Rao N, Cannella B, Crossett LS, Yates AJ Jr, McGough R 3rd (2008) A preoperative decolonization protocol for Staphylococcus aureus prevents orthopaedic infections. Clin Orthop Relat Res 466:1343–1348. PMCID: 2384036PubMedGoogle Scholar
  184. 184.
    Jog S, Cunningham R, Cooper S, Wallis M, Marchbank A, Vasco-Knight P et al (2008) Impact of preoperative screening for methicillin-resistant Staphylococcus aureus by real-time polymerase chain reaction in patients undergoing cardiac surgery. J Hosp Infect 69:124–130PubMedGoogle Scholar
  185. 185.
    Bode LG, Kluytmans JA, Wertheim HF, Bogaers D, Vandenbroucke-Grauls CM, Roosendaal R et al (2010) Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N Engl J Med 362:9–17PubMedGoogle Scholar
  186. 186.
    Wertheim HF, Vos MC, Ott A, Voss A, Kluytmans JA, Vandenbroucke-Grauls CM et al (2004) Mupirocin prophylaxis against nosocomial Staphylococcus aureus infections in nonsurgical patients: a randomized study. Ann Intern Med 140:419–425PubMedGoogle Scholar
  187. 187.
    Robicsek A, Beaumont JL, Thomson RB Jr, Govindarajan G, Peterson LR (2009) Topical therapy for methicillin-resistant Staphylococcus aureus colonization: impact on infection risk. Infect Control Hosp Epidemiol 30:623–632PubMedGoogle Scholar
  188. 188.
    Fernandez C, Gaspar C, Torrellas A, Vindel A, Saez-Nieto JA, Cruzet F et al (1995) A double-blind, randomized, placebo-controlled clinical trial to evaluate the safety and efficacy of mupirocin calcium ointment for eliminating nasal carriage of Staphylococcus aureus among hospital personnel. J Antimicrob Chemother 35:399–408PubMedGoogle Scholar
  189. 189.
    Martin JN, Perdreau-Remington F, Kartalija M, Pasi OG, Webb M, Gerberding JL et al (1999) A randomized clinical trial of mupirocin in the eradication of Staphylococcus aureus nasal carriage in human immunodeficiency virus disease. J Infect Dis 180:896–899PubMedGoogle Scholar
  190. 190.
    Evans HL, Dellit TH, Chan J, Nathens AB, Maier RV, Cuschieri J (2010) Effect of chlorhexidine whole-body bathing on hospital-acquired infections among trauma patients. Arch Surg 145:240–246PubMedGoogle Scholar
  191. 191.
    Climo MW, Sepkowitz KA, Zuccotti G, Fraser VJ, Warren DK, Perl TM et al (2009) The effect of daily bathing with chlorhexidine on the acquisition of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and healthcare-associated bloodstream infections: results of a quasi-experimental multicenter trial. Crit Care Med 37:1858–1865PubMedGoogle Scholar
  192. 192.
    Vernon MO, Hayden MK, Trick WE, Hayes RA, Blom DW, Weinstein RA (2006) Chlorhexidine gluconate to cleanse patients in a medical intensive care unit: the effectiveness of source control to reduce the bioburden of vancomycin-resistant enterococci. Arch Intern Med 166:306–312PubMedGoogle Scholar
  193. 193.
    Borer A, Gilad J, Porat N, Megrelesvilli R, Saidel-Odes L, Peled N et al (2007) Impact of 4% chlorhexidine whole-body washing on multidrug-resistant Acinetobacter baumannii skin colonisation among patients in a medical intensive care unit. J Hosp Infect 67:149–155PubMedGoogle Scholar
  194. 194.
    Paterson DL, Singh N, Rihs JD, Squier C, Rihs BL, Muder RR (2001) Control of an outbreak of infection due to extended-spectrum beta-lactamase–producing Escherichia coli in a liver transplantation unit. Clin Infect Dis 33:126–128PubMedGoogle Scholar
  195. 195.
    Troche G, Joly LM, Guibert M, Zazzo JF (2005) Detection and treatment of antibiotic-resistant bacterial carriage in a surgical intensive care unit: a 6-year prospective survey. Infect Control Hosp Epidemiol 26:161–165PubMedGoogle Scholar
  196. 196.
    Buehlmann M, Bruderer T, Frei R, Widmer AF (2011) Effectiveness of a new decolonisation regimen for eradication of extended-spectrum beta-lactamase-producing Enterobacteriaceae. J Hosp Infect 77:113–117PubMedGoogle Scholar
  197. 197.
    Zuckerman T, Benyamini N, Sprecher H, Fineman R, Finkelstein R, Rowe JM et al (2011) SCT in patients with carbapenem resistant Klebsiella pneumoniae: a single center experience with oral gentamicin for the eradication of carrier state. Bone Marrow Transplant 46(9):1226–1230Google Scholar
  198. 198.
    de Smet AM, Kluytmans JA, Blok HE, Mascini EM, Benus RF, Bernards AT et al (2011) Selective digestive tract decontamination and selective oropharyngeal decontamination and antibiotic resistance in patients in intensive-care units: an open-label, clustered group-randomised, crossover study. Lancet Infect Dis 11:372–380PubMedGoogle Scholar
  199. 199.
    Prescott JF (2008) Antimicrobial use in food and companion animals. Anim Health Res Rev 9:127–133PubMedGoogle Scholar
  200. 200.
    WHO (1998) Use of quinolones in food animals and potential impact on human health. World Health Organization, GenevaGoogle Scholar
  201. 201.
    Smith KE, Besser JM, Hedberg CW, Leano FT, Bender JB, Wicklund JH et al (1999) Quinolone-resistant Campylobacter jejuni infections in Minnesota, 1992-1998. Investigation Team. N Engl J Med 340:1525–1532PubMedGoogle Scholar
  202. 202.
    Endtz HP, Ruijs GJ, van Klingeren B, Jansen WH, van der Reyden T, Mouton RP (1991) Quinolone resistance in Campylobacter isolated from man and poultry following the introduction of fluoroquinolones in veterinary medicine. J Antimicrob Chemother 27:199–208PubMedGoogle Scholar
  203. 203.
    Engberg J, Aarestrup FM, Taylor DE, Gerner-Smidt P, Nachamkin I (2001) Quinolone and macrolide resistance in Campylobacter jejuni and C. coli: resistance mechanisms and trends in human isolates. Emerg Infect Dis 7:24–34. PMCID: 2631682PubMedGoogle Scholar
  204. 204.
    Holmberg SD, Solomon SL, Blake PA (1987) Health and economic impacts of antimicrobial resistance. Rev Infect Dis 9:1065–1078PubMedGoogle Scholar
  205. 205.
    Lee LA, Puhr ND, Maloney EK, Bean NH, Tauxe RV (1994) Increase in antimicrobial-­resistant Salmonella infections in the United States, 1989–1990. J Infect Dis 170:128–134PubMedGoogle Scholar
  206. 206.
    WHO (2003) Joint FAO/OIE/WHO expert workshop on non-human antimicrobial usage and antimicorbial resistance: scientific assessment. World Health Organization, GenevaGoogle Scholar
  207. 207.
    Nelson JM, Chiller TM, Powers JH, Angulo FJ (2007) Fluoroquinolone-resistant Campylobacter species and the withdrawal of fluoroquinolones from use in poultry: a public health success story. Clin Infect Dis 44:977–980PubMedGoogle Scholar
  208. 208.
    Doi Y, Paterson DL, Egea P, Pascual A, Lopez-Cerero L, Navarro MD et al (2010) Extended-spectrum and CMY-type beta-lactamase-producing Escherichia coli in clinical samples and retail meat from Pittsburgh, USA and Seville, Spain. Clin Microbiol Infect 16:33–38PubMedGoogle Scholar
  209. 209.
    Smith HW (1969) Transfer of antibiotic resistance from animal and human strains of Escherichia coli to resident E. coli in the alimentary tract of man. Lancet 1:1174–1176PubMedGoogle Scholar
  210. 210.
    Trobos M, Lester CH, Olsen JE, Frimodt-Moller N, Hammerum AM (2009) Natural transfer of sulphonamide and ampicillin resistance between Escherichia coli residing in the human intestine. J Antimicrob Chemother 63:80–86PubMedGoogle Scholar
  211. 211.
    Johnson JR, Sannes MR, Croy C, Johnston B, Clabots C, Kuskowski MA et al (2007) Antimicrobial drug-resistant Escherichia coli from humans and poultry products, Minnesota and Wisconsin, 2002-2004. Emerg Infect Dis 13:838–846. PMCID: 2792839PubMedGoogle Scholar
  212. 212.
    Hardy B (2002) The issue of antibiotic use in the livestock industry: what have we learned? Anim Biotechnol 13:129–147PubMedGoogle Scholar
  213. 213.
    Klare I, Heier H, Claus H, Reissbrodt R, Witte W (1995) vanA-mediated high-level glycopeptide resistance in Enterococcus faecium from animal husbandry. FEMS Microbiol Lett 125:165–171PubMedGoogle Scholar
  214. 214.
    Schouten MA, Voss A, Hoogkamp-Korstanje JA (1997) VRE and meat. Lancet 349:1258PubMedGoogle Scholar
  215. 215.
    Jensen LB, Ahrens P, Dons L, Jones RN, Hammerum AM, Aarestrup FM (1998) Molecular analysis of Tn1546 in Enterococcus faecium isolated from animals and humans. J Clin Microbiol 36:437–442. PMCID: 104555PubMedGoogle Scholar
  216. 216.
    Stobberingh E, van den Bogaard A, London N, Driessen C, Top J, Willems R (1999) Enterococci with glycopeptide resistance in turkeys, turkey farmers, turkey slaughterers, and (sub)urban residents in the south of The Netherlands: evidence for transmission of vancomycin resistance from animals to humans? Antimicrob Agents Chemother 43:2215–2221. PMCID: 89449PubMedGoogle Scholar
  217. 217.
    Klare I, Badstubner D, Konstabel C, Bohme G, Claus H, Witte W (1999) Decreased incidence of VanA-type vancomycin-resistant enterococci isolated from poultry meat and from fecal samples of humans in the community after discontinuation of avoparcin usage in animal husbandry. Microb Drug Resist 5:45–52PubMedGoogle Scholar
  218. 218.
    WHO (2002) Impacts of antimicrobial growth promoter termination in Denmark. World Health Organization, GenevaGoogle Scholar
  219. 219.
    WHO (2007) Critically important antimicrobials for human medicine: categorization for the development of risk management strategies to contain antimicrobial resistance due to non-human antimicrobial use. In: Report of the 2nd WHO expert meeting, Copenhagen, DenmarkGoogle Scholar
  220. 220.
    FDA (2010) The judicious use of medically-important antimicrobial drugs in food-producing animals. The Food and Drug Administration, Washington, DCGoogle Scholar
  221. 221.
    Wenzel RP (2004) The antibiotic pipeline–challenges, costs, and values. N Engl J Med 351:523–526PubMedGoogle Scholar
  222. 222.
    Stewart JJ, Allison PN, Johnson RS (2001) Putting a price on biotechnology. Nat Biotechnol 19:813–817PubMedGoogle Scholar
  223. 223.
    Projan SJ (2003) Why is big Pharma getting out of antibacterial drug discovery? Curr Opin Microbiol 6:427–430PubMedGoogle Scholar
  224. 224.
    Fox JL (2006) The business of developing antibacterials. Nat Biotechnol 24(12):1521–1528PubMedGoogle Scholar
  225. 225.
    Powers JH (2003) Development of drugs for antimicrobial-resistant pathogens. Curr Opin Infect Dis 16:547–551PubMedGoogle Scholar
  226. 226.
    Moellering RC Jr (2011) Discovering new antimicrobial agents. Int J Antimicrob Agents 37:2–9PubMedGoogle Scholar
  227. 227.
    Payne DJ, Gwynn MN, Holmes DJ, Pompliano DL (2007) Drugs for bad bugs: confronting the challenges of antibacterial discovery. Nat Rev Drug Discov 6:29–40PubMedGoogle Scholar
  228. 228.
    Page MG, Dantier C, Desarbre E (2010) In vitro properties of BAL30072, a novel siderophore sulfactam with activity against multiresistant gram-negative bacilli. Antimicrob Agents Chemother 54:2291–2302. PMCID: 2876421PubMedGoogle Scholar
  229. 229.
    Drawz SM, Bonomo RA (2010) Three decades of beta-lactamase inhibitors. Clin Microbiol Rev 23:160–201. PMCID: 2806661PubMedGoogle Scholar
  230. 230.
    Hancock RE, Chapple DS (1999) Peptide antibiotics. Antimicrob Agents Chemother 43:1317–1323. PMCID: 89271PubMedGoogle Scholar
  231. 231.
    Levin M, Quint PA, Goldstein B, Barton P, Bradley JS, Shemie SD et al (2000) Recombinant bactericidal/permeability-increasing protein (rBPI21) as adjunctive treatment for children with severe meningococcal sepsis: a randomised trial. rBPI21 Meningococcal Sepsis Study Group. Lancet 356:961–967PubMedGoogle Scholar
  232. 232.
    Barrett JF, Hoch JA (1998) Two-component signal transduction as a target for microbial anti-infective therapy. Antimicrob Agents Chemother 42:1529–1536. PMCID: 105640PubMedGoogle Scholar
  233. 233.
    Moir DT, Shaw KJ, Hare RS, Vovis GF (1999) Genomics and antimicrobial drug discovery. Antimicrob Agents Chemother 43:439–446. PMCID: 89141PubMedGoogle Scholar
  234. 234.
    Garnacho-Montero J, Ortiz-Leyba C, Jimenez-Jimenez FJ, Barrero-Almodovar AE, Garcia-Garmendia JL, Bernabeu-Wittel IM et al (2003) Treatment of multidrug-resistant Acinetobacter baumannii ventilator-associated pneumonia (VAP) with intravenous colistin: a comparison with imipenem-susceptible VAP. Clin Infect Dis 36:1111–1118PubMedGoogle Scholar
  235. 235.
    Michalopoulos A, Virtzili S, Rafailidis P, Chalevelakis G, Damala M, Falagas ME (2010) Intravenous fosfomycin for the treatment of nosocomial infections caused by carbapenem-resistant Klebsiella pneumoniae in critically ill patients: a prospective evaluation. Clin Microbiol Infect 16:184–186PubMedGoogle Scholar
  236. 236.
    Falagas ME, Kanellopoulou MD, Karageorgopoulos DE, Dimopoulos G, Rafailidis PI, Skarmoutsou ND et al (2008) Antimicrobial susceptibility of multidrug-resistant gram negative bacteria to fosfomycin. Eur J Clin Microbiol Infect Dis 27:439–443PubMedGoogle Scholar
  237. 237.
    Cunha BA (2006) New uses for older antibiotics: nitrofurantoin, amikacin, colistin, polymyxin B, doxycycline, and minocycline revisited. Med Clin North Am 90:1089–1107PubMedGoogle Scholar
  238. 238.
    Alanis AJ (2005) Resistance to antibiotics: are we in the post-antibiotic era? Arch Med Res 36:697–705PubMedGoogle Scholar
  239. 239.
    WHO (2001) WHO global strategy for containment of antimicrobial resistance. World Health Organization, GenevaGoogle Scholar
  240. 240.
    IDSA (2010) The 10 x ‘20 initiative: pursuing a global commitment to develop 10 new antibacterial drugs by 2020. Clin Infect Dis 50:1081–1083Google Scholar
  241. 241.
    Gaynes RP (2010) Preserving the effectiveness of antibiotics. JAMA 303:2293–2294PubMedGoogle Scholar
  242. 242.
    ECDC (2010) Annual epidemiological report on communicable diseases in Europe 2010. European Centre for Disease Control and Prevention, StockholmGoogle Scholar
  243. 243.
    Buising KL, Thursky KA, Robertson MB, Black JF, Street AC, Richards MJ et al (2008) Electronic antibiotic stewardship–reduced consumption of broad-spectrum antibiotics using a computerized antimicrobial approval system in a hospital setting. J Antimicrob Chemother 62:608–616PubMedGoogle Scholar
  244. 244.
    Raymond DP, Pelletier SJ, Crabtree TD, Gleason TG, Hamm LL, Pruett TL et al (2001) Impact of a rotating empiric antibiotic schedule on infectious mortality in an intensive care unit. Crit Care Med 29:1101–1108PubMedGoogle Scholar
  245. 245.
    Cook PP, Catrou P, Gooch M, Holbert D (2006) Effect of reduction in ciprofloxacin use on prevalence of methicillin-resistant Staphylococcus aureus rates within individual units of a tertiary care hospital. J Hosp Infect 64:348–351PubMedGoogle Scholar
  246. 246.
    Rahal JJ, Urban C, Horn D, Freeman K, Segal-Maurer S, Maurer J et al (1998) Class restriction of cephalosporin use to control total cephalosporin resistance in nosocomial Klebsiella. JAMA 280:1233–1237PubMedGoogle Scholar
  247. 247.
    Bantar C, Sartori B, Vesco E, Heft C, Saul M, Salamone F et al (2003) A hospitalwide intervention program to optimize the quality of antibiotic use: impact on prescribing practice, antibiotic consumption, cost savings, and bacterial resistance. Clin Infect Dis 37:180–186PubMedGoogle Scholar
  248. 248.
    Lipsky BA, Baker CA, McDonald LL, Suzuki NT (1999) Improving the appropriateness of vancomycin use by sequential interventions. Am J Infect Control 27:84–91PubMedGoogle Scholar
  249. 249.
    Mol PG, Wieringa JE, Nannanpanday PV, Gans RO, Degener JE, Laseur M et al (2005) Improving compliance with hospital antibiotic guidelines: a time-series intervention analysis. J Antimicrob Chemother 55:550–557PubMedGoogle Scholar
  250. 250.
    Solomon DH, Van Houten L, Glynn RJ, Baden L, Curtis K, Schrager H et al (2001) Academic detailing to improve use of broad-spectrum antibiotics at an academic medical center. Arch Intern Med 161:1897–1902PubMedGoogle Scholar
  251. 251.
    Evans RS, Pestotnik SL, Classen DC, Clemmer TP, Weaver LK, Orme JF Jr et al (1998) A computer-assisted management program for antibiotics and other antiinfective agents. N Engl J Med 338:232–238PubMedGoogle Scholar
  252. 252.
    Gross R, Morgan AS, Kinky DE, Weiner M, Gibson GA, Fishman NO (2001) Impact of a hospital-based antimicrobial management program on clinical and economic outcomes. Clin Infect Dis 33:289–295PubMedGoogle Scholar
  253. 253.
    Seligman SJ (1981) Reduction in antibiotic costs by restricting use of an oral cephalosporin. Am J Med 71:941–944PubMedGoogle Scholar
  254. 254.
    Woodward RS, Medoff G, Smith MD, Gray JL 3rd (1987) Antibiotic cost savings from formulary restrictions and physician monitoring in a medical-school-affiliated hospital. Am J Med 83:817–823PubMedGoogle Scholar
  255. 255.
    Glowacki RC, Schwartz DN, Itokazu GS, Wisniewski MF, Kieszkowski P, Weinstein RA (2003) Antibiotic combinations with redundant antimicrobial spectra: clinical epidemiology and pilot intervention of computer-assisted surveillance. Clin Infect Dis 37:59–64PubMedGoogle Scholar
  256. 256.
    Fraser GL, Stogsdill P, Dickens JD Jr, Wennberg DE, Smith RP Jr, Prato BS (1997) Antibiotic optimization. An evaluation of patient safety and economic outcomes. Arch Intern Med 157:1689–1694PubMedGoogle Scholar
  257. 257.
    Coleman RW, Rodondi LC, Kaubisch S, Granzella NB, O’Hanley PD (1991) Cost-effectiveness of prospective and continuous parenteral antibiotic control: experience at the Palo Alto Veterans Affairs Medical Center from 1987 to 1989. Am J Med 90:439–444PubMedGoogle Scholar
  258. 258.
    Omidvari K, de Boisblanc BP, Karam G, Nelson S, Haponik E, Summer W (1998) Early transition to oral antibiotic therapy for community-acquired pneumonia: duration of therapy, clinical outcomes, and cost analysis. Respir Med 92:1032–1039PubMedGoogle Scholar
  259. 259.
    Fowler S, Webber A, Cooper BS, Phimister A, Price K, Carter Y et al (2007) Successful use of feedback to improve antibiotic prescribing and reduce Clostridium difficile infection: a controlled interrupted time series. J Antimicrob Chemother 59:990–995PubMedGoogle Scholar
  260. 260.
    Valiquette L, Cossette B, Garant MP, Diab H, Pepin J (2007) Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile-associated disease caused by the hypervirulent NAP1/027 strain. Clin Infect Dis 45(Suppl 2): S112–S121PubMedGoogle Scholar
  261. 261.
    Pope SD, Dellit TH, Owens RC, Hooton TM (2009) Results of survey on implementation of Infectious Diseases Society of America and Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Infect Control Hosp Epidemiol 30:97–98PubMedGoogle Scholar
  262. 262.
    Shlaes DM, Gerding DN, John JF Jr, Craig WA, Bornstein DL, Duncan RA et al (1997) Society for Healthcare Epidemiology of America and Infectious Diseases Society of America Joint Committee on the Prevention of Antimicrobial Resistance: guidelines for the prevention of antimicrobial resistance in hospitals. Clin Infect Dis 25:584–599PubMedGoogle Scholar
  263. 263.
    Drew RH (2009) Antimicrobial stewardship programs: how to start and steer a successful program. J Manag Care Pharm 15:S18–S23PubMedGoogle Scholar
  264. 264.
    Fridkin SK (2003) Routine cycling of antimicrobial agents as an infection-control measure. Clin Infect Dis 36:1438–1444PubMedGoogle Scholar
  265. 265.
    Paskovaty A, Pflomm JM, Myke N, Seo SK (2005) A multidisciplinary approach to antimicrobial stewardship: evolution into the 21st century. Int J Antimicrob Agents 25:1–10PubMedGoogle Scholar
  266. 266.
    Fox BC, Imrey PB, Voights MB, Norwood S (2001) Infectious disease consultation and microbiologic surveillance for intensive care unit trauma patients: a pilot study. Clin Infect Dis 33:1981–1989PubMedGoogle Scholar
  267. 267.
    Dos Santos EF, Silva AE, Pinhati HM, Maia Mde O (2003) Effectiveness of the actions of antimicrobial control in the intensive care unit. Braz J Infect Dis 7:290–296PubMedGoogle Scholar
  268. 268.
    Sintchenko V, Iredell JR, Gilbert GL, Coiera E (2005) Handheld computer-based decision support reduces patient length of stay and antibiotic prescribing in critical care. J Am Med Inform Assoc 12:398–402. PMCID: 1174884PubMedGoogle Scholar
  269. 269.
    Yong MK, Buising KL, Cheng AC, Thursky KA (2010) Improved susceptibility of Gram-negative bacteria in an intensive care unit following implementation of a computerized antibiotic decision support system. J Antimicrob Chemother 65:1062–1069PubMedGoogle Scholar
  270. 270.
    Rao SR, Desroches CM, Donelan K, Campbell EG, Miralles PD, Jha AK (2011) Electronic health records in small physician practices: availability, use, and perceived benefits. J Am Med Inform Assoc 18:271–275PubMedGoogle Scholar
  271. 271.
    Gaynes RP, Gould CV, Edwards J, Antoine TL, Blumberg HM, Desilva K et al (2009) A multicenter study on optimizing piperacillin-tazobactam use: lessons on why interventions fail. Infect Control Hosp Epidemiol 30:794–796PubMedGoogle Scholar
  272. 272.
    Morel J, Casoetto J, Jospe R, Aubert G, Terrana R, Dumont A et al (2010) De-escalation as part of a global strategy of empiric antibiotherapy management. A retrospective study in a medico-surgical intensive care unit. Crit Care 14:R225PubMedGoogle Scholar
  273. 273.
    Bauer KA, West JE, Balada-Llasat JM, Pancholi P, Stevenson KB, Goff DA (2010) An antimicrobial stewardship program’s impact with rapid polymerase chain reaction methicillin-resistant Staphylococcus aureus/S. aureus blood culture test in patients with S. aureus bacteremia. Clin Infect Dis 51:1074–1080PubMedGoogle Scholar
  274. 274.
    Nguyen DT, Yeh E, Perry S, Luo RF, Pinsky BA, Lee BP et al (2010) Real-time PCR testing for mecA reduces vancomycin usage and length of hospitalization for patients infected with methicillin-sensitive staphylococci. J Clin Microbiol 48:785–790. PMCID: 2832423PubMedGoogle Scholar
  275. 275.
    Rello J, Vidaur L, Sandiumenge A, Rodriguez A, Gualis B, Boque C et al (2004) De-escalation therapy in ventilator-associated pneumonia. Crit Care Med 32:2183–2190PubMedGoogle Scholar
  276. 276.
    Niederman MS (2006) De-escalation therapy in ventilator-associated pneumonia. Curr Opin Crit Care 12:452–457PubMedGoogle Scholar
  277. 277.
    Reinhart K, Hartog CS (2010) Biomarkers as a guide for antimicrobial therapy. Int J Antimicrob Agents 36(Suppl 2):S17–S21PubMedGoogle Scholar
  278. 278.
    Nobre V, Harbarth S, Graf JD, Rohner P, Pugin J (2008) Use of procalcitonin to shorten antibiotic treatment duration in septic patients: a randomized trial. Am J Respir Crit Care Med 177:498–505PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Daniel Livorsi
    • 1
    • 2
  • Edward Stenehjem
    • 1
    • 2
  • Robert Gaynes
    • 1
    • 2
  1. 1.Division of Infectious Diseases, Department of MedicineEmory University School of MedicineAtlantaUSA
  2. 2.Atlanta VA Medical CenterAtlantaUSA

Personalised recommendations