Infections caused by multi drug resistant organisms are estimated to cause 35,000 deaths in the US every year, and increase medical costs by $4.5 billion.
Includes methicillin resistant Staphylococcus aureus (MRSA) and vancomycin resistant enterococcus (VRE), carbapenem resistant acinetobacter and Pseudo areuginosa infections.
These organisms have become endemic in many acute-care and long-term care health facilities.
Infections with these organisms are difficult to treat due to a decreasing armamentarium in active antimicrobial agents.
Multi drug resistant organism colonization rates among residence of long-term care facilities, are often far higher than those observed in tertiary care referral facilities.
The prevalence of MDR organisms in long-term care reaches 40 to 65% in nursing homes and 80% in long-term acute care hospitals.
Typical hospital prevalence of MDR organisms is 10 to 15%.
Incidence of several MDR pathogens has decreased: MRSA, VRE, carbapenem resistant acinetobacter and Pseudo areuginosa infections.
The incidence of extended spectrum beta-lactamase producing enterobactericeae significantly increased recently.
The combination of bedaquiline, preomanid, and linezolid led to a favorable outcome at six months after the end of therapy in a high percentage of patients with highly drug resistant forms of tuberculosis (Conradie F).
Prevention strategies include body surface decolonization, using antiseptic soap, and nasal products have been adopted in high risk patient populations, demonstrating reductions in bloodstream infections and MDR organism carriage: a study of the decontamination process was associated with lower MDR organism carriage, infections, hospitalizations, costs, and deaths (Gussin GM).
Widespread manifestations of nonresponsive dermatophytosis has been occurring;ringworm, tinea, T. indotineae.