Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2024
[Multi-resistant bacteria - epidemiological trends and new treatment options].
Multi-resistant bacteria such as Escherichia coli and Klebsiella pneumoniae are a growing threat worldwide. The spread of Carbapenemase-producing strains is particularly worrying. New antibiotics and combination therapies offer treatment options, but the development of resistant pathogens remains a major challenge.
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Dtsch. Med. Wochenschr. · Sep 2024
[Importance and prevalence of multidrug-resistant gram-negative bacteria in Germany].
Infections with multidrug-resistant gram-negative bacterial species are a great concern in clinics in Germany. By limiting therapeutic options dramatically, these bacteria pose a significant threat to patient health and cause extensive pressure on hygiene systems and patient management. ⋯ According to established surveillance systems like national reporting systems, KISS or the National Reference Centre, multidrug-resistant bacteria are constantly on the rise in Germany. Although several novel therapeutic options have been approved recently, these bacteria represent a constant challenge and it may be necessary to discuss if the present hygiene recommendations need an update for an efficient and targeted prevention of transmission.
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Dtsch. Med. Wochenschr. · Sep 2024
Review[Small intestinal bacterial overgrowth (SIBO) - Therapy, nutrition, microbiome].
SIBO (small intestinal bacterial overgrowth) is defined by bacterial overgrowth or colonization of the small intestine in combination with gastrointestinal symptoms such as bloating, nausea, pain, diarrhoea, malabsorption and food intolerance. SIBO can be caused by various mechanisms such as reduced intestinal motility, altered gastrointestinal anatomy, reduced gastric acid or pancreatic enzyme production, altered bile acid metabolism, or immune defects. Accordingly, SIBO often develops secondary to different underlying diseases. ⋯ However, both aspects have so far been insufficiently investigated. Nevertheless, elemental diets, carbohydrate-reduced diets, as well as pre- and probiotics are potential therapy options. This article provides a summary of current knowledge on the pathophysiology, diagnosis and treatment of SIBO, with particular emphasis on the role of nutrition and the microbiome.
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Dtsch. Med. Wochenschr. · Sep 2024
Review[Multi-resistant pathogens - are they also resistant to disinfectants?].
Epidemiological studies show that the care of patients in rooms with a previous stay by a person with evidence of multi-resistant pathogens (MRP) is associated with an increased risk of these pathogens occurring. The question therefore regularly arises as to whether MRP also exhibit resistance to the disinfectants used. To date, there are no standardised definitions for "resistance" to disinfectants. ⋯ A reduced sensitivity to disinfectants can occur in individual isolates due to selection under sub-inhibitory concentrations of disinfectants. Resistance mechanisms to antibiotics do not mediate cross-resistance to disinfectants, but a change in the permeability of bacterial cells can influence sensitivity to disinfectants and antibiotics. In general, the success of routine disinfection can be improved by suitable process controls and contribute to reducing the transmission of MRP.