Infections Caused by Nonfermenting Gram-negative Rods: Epidemiological, Microbiological and Clinical Features

Clinical Microbiology and Antimicrobial Chemotherapy. 2005; 7(3):271-285

Journal article


Nonfermenting gram-negative rods (NGR) are one of the leading nosocomial pathogens. Among them Pseudomonas aeruginosa, Acinetobacter baumannii, Pseudomonas aeruginosa, Acinetobacter spp., Burkholderia spp., Stenotrophomonas spp., and Chryseobacterium spp. are of clinical importance. NGR usually cause infections in patients with predisposing conditions, such as immunocompromise status, previous administration of broad-spectrum antimicrobials, artificial ventilation, malignancies, etc. P. aeruginosa and B. cepacia, play major role in lower respiratory tract infections in patients with cystic fibrosis. The most important feature of NGR from clinical point of view is high rates of resistance to different classes of antimicrobials. Majority of multiresistance problems linked to active efflux systems, among which MexAB-OprM, MexCD-OprJ, MexEFOprN and MexXY in P. aeruginosa are studied in details; similar systems described in Stenotrophomonas spp., Acinetobacter baumannii, B. pseudomallei. Another important characteristics of NGR are so called «quorum sensing» – the mechanism that controls the production of many factors of pathogenicity, and ability to form biofilm, the structure and physiological nature of which provide decreased susceptibility to antibiotics, antiseptics, and to immune system. In present review the taxonomy and epidemiology of NGR are also discussed.

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