Opportunistic nosocomial multiply resistant bacterial infections--their treatment and prevention

One of the most difficult problems confronting the clinician who deals with nosocomial infections is that of microbial resistance. The predominant nosocomial infections (urinary tract infections, pneumonia, septicaemia, surgical wound infections) involve increasing numbers of Gram-positive bacteria, Staphylococcus epidermidis, Corynebacterium jeikeium or resistant enterococci as well as new multiresistant Gram-negative bacilli such as Xanthomonas maltophilia, Acinetobacter baumannii and Alcaligenes xylosoxydans. The emergence and spread of Klebsiella pneumoniae and other Enterobacteriaceae producing novel plasmid-mediated beta-lactamases active against third-generation cephalosporins contribute to the difficulty in treating nosocomial infections.