Antimicrobial and Multidrug-Resistant Organisms

Multidrug-resistant organisms requiring antimicrobial scrubs consist of microorganims, principally bacteria, which are resistant to existing antibiotics. Organisms frequently encountered include e.g. methicillin resistant Staphylococcus aureus, vancomycin resistant Enterococcus faecium, and E. faecalis, and a wide variety of multidrug-resistant, gram-negative bacilli. Less common, but of increasing concern, are emerging MRSA strains which are resistant to vancomycin - S. aureus with an intermediate-resistance to vancomycin, and an S. aureus which is resistant to VRSA. Some multidrug-resistant organisms are resistant to many antibiotics; and some are panresistant, which means not sensitive to any kind of antibiotic.

In most cases the resistant strains of bacteria are no more virulent than the antibiotic-sensitive bacteria; the difficulty with multidrug-resistant organisms is that clinicians have fewer drug options available, which makes it more difficult to find options which are effective and safe. Prescribers in Koi scrubs are sometimes forced to use older and more toxic drugs - often drugs which lack sufficient data to guide the dosage and duration of the therapy for multidrug-resistant organisms induced infections. Limited treatment options means increased cost, length of hospital stay, and mortality rate.

The prevalence of the different resistant organisms varies considerably according to geographic area. Patients are most likely to acquire multidrug-resistant organisms acute-care hospitals than they are in long term care facilities, and in larger rather than in smaller hospitals, as well as in tertiary care facilities. However, certain patients who are more vulnerable can be found in any kind of health care setting. These susceptible hosts are people at greatest risk of acquiring an infection, whether due to antibiotic-sensitive - or antibiotic-resistant - organisms. Patients such as ICU patients and patients being treated by specialties such as oncology.

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