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Review article
Available online 26 May 2022
The role of the microbiology laboratory in the diagnosis of multidrug-resistant Gram-negative bacilli infections. The importance of figuring out resistance mechanisms
El papel del laboratorio de microbiología en el diagnóstico de infecciones por bacilos gramnegativos multirresistentes. Importancia de la determinación de mecanismos de resistencias
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I. López-Hernándeza,b,c,d, L. López-Cereroa,b,c,d, F. Fernández-Cuencaa,b,c,d,
Corresponding author
felipefc@us.es

Corresponding author.
, Á. Pascuala,b,c,d
a Unidad de Enfermedades Infecciosas y Microbiología Clínica, Hospital Universitario Virgen Macarena, Sevilla, Spain
b Departamento de Microbiología, Universidad de Sevilla, Sevilla, Spain
c Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla, Sevilla, Spain
d Red Española de Investigación en Patología Infecciosa (REIPI RD16/0016), Instituto de Salud Carlos III, Madrid, Spain
Received 18 October 2021. Accepted 12 January 2022
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Tables (4)
Table 1. Microbiological analysis of a culture of different samples.
Table 2. Technical characteristics for the rapid detection of resistance in MR-GNB.
Table 3. Identification systems of sepsis-producing pathogens and resistance determinants approved by the FDA.
Table 4. Most significant characteristics of some molecular typification methods of BGN MDR.
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Abstract

Early diagnosis and treatment has an important impact on the morbidity and mortality of infections caused by multidrug-resistant bacteria. Multidrug-resistant gram-negative bacilli (MR-GNB) constitute the main current threat in hospitals and especially in intensive care units (ICU). The role of the microbiology laboratory is essential in providing a rapid and effective response. This review updates the microbiology laboratory procedures for the rapid detection of BGN-MR and its resistance determinants. The role of the laboratory in the surveillance and control of outbreaks caused by these bacteria, including typing techniques, is also studied. The importance of providing standardized resistance maps that allow knowing the epidemiological situation of the different units is emphasized. Finally, the importance of effective communication systems for the transmission of results and decision making in the management of patients infected by BGN-MR is reviewed.

Keywords:
Infections
Multidrug-resistant gram-negative bacilli
Microbiology laboratory
Resistance mechanisms
Resumen

Un diagnóstico y tratamiento precoz tiene un impacto importante en la morbilidad y mortalidad de las infecciones producidas por bacterias multirresistentes. Los Bacilos gramnegativos multirresistentes (BGN-MR) constituye la principal amenaza actual en los hospitales y muy especialmente en las unidades de cuidados intensivos (UCI). El papel del laboratorio de microbiología es esencial en dar una respuesta rápida y eficaz. En esta revisión se actualiza los procedimientos del laboratorio de Microbiología para la detección rápida de los BGN-MR y de sus determinantes de resistencia. También se estudia el papel del laboratorio en la vigilancia y control de brotes por estas bacterias, incluyendo las técnicas de tipificación. Se destaca la importancia de proporcionar mapas de resistencia normalizados que permita conocer la situación epidemiológica de las diferentes unidades. Finalmente se revisa la importancia de sistemas de comunicación eficaces para la transmisión de resultados y la toma de decisiones en el manejo de pacientes infectados por BGN-MR.

Palabras clave:
Infecciones
Bacilos gramnegativos multirresistentes
Laboratorio de microbiología
Mecanismos de resistencia

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