Multi-resistant Infections: Current Knowledge and Strategies

The introduction of penicillin for clinical use in the 1940s has led to great improvements in the management of bacterial infections and to significant advances in surgical procedures both in human and in veterinary medicine. Before effective antimicrobial drugs became available, many S. aureus infections in people were fatal with over 80% mortality reported for bacteraemia cases. However, bacteria continuously evolve and can adapt rapidly and they have been able to develop resistance mechanisms to virtually all antimicrobials used.

Infections due to multidrug-resistant (MDR) bacteria can have major implications on the patient’s recovery as treatment may be prolonged, associated with more frequent and more serious side effects (as less commonly used antimicrobial drugs are needed) and may lead to substantially increased cost compared to infection with susceptible pathogens. Furthermore, many MDR pathogens can infect animals and humans and zoonotic transmission is often documented in both directions between hosts. This has implications for public health and may require comprehensive infection control strategies and owner education.

The most important MDR pathogens involved in wound infections in animals include meticillin-resistant Staphylococcus aureus (MRSA) and meticillin-resistant S. pseudintermedius (MRSP) but Pseudomonas aeruginosa (particularly through formation of biofilm in wounds), E. coli and Acinetobacter spp. may also present as challenging pathogens.  [...]