{"id":1237,"date":"2017-03-02T21:10:19","date_gmt":"2017-03-02T21:10:19","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=1237"},"modified":"2017-08-21T10:20:39","modified_gmt":"2017-08-21T10:20:39","slug":"primary-care-corner-with-geoffrey-modest-md-antibiotic-resistant-bacteria-of-concern","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2017\/03\/02\/primary-care-corner-with-geoffrey-modest-md-antibiotic-resistant-bacteria-of-concern\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: antibiotic-resistant bacteria of concern"},"content":{"rendered":"

By Dr. Geoffrey Modest<\/strong><\/p>\n

The WHO just published a list of 12 bacterial families that they feel pose the greatest threat to human health (see\u00a0http:\/\/www.who.int\/mediacentre\/news\/releases\/2017\/bacteria-antibiotics-needed\/en\/<\/a> ). These are considered the “priority pathogens”, which should serve as a focus for research and development of new antibiotics. The most critical group includes multi-drug-resistant bacteria that pose a particular threat\u00a0in hospitals, nursing homes, and among patients who require devices such as ventilators and blood catheters. These bacteria have become resistant to a large number of antibiotics including carbapenems and third-generation cephalosporins, the best available drugs for treating multidrug resistant bacteria. The 2nd<\/sup> and 3rd<\/sup> tier priorities include increasingly drug-resistant bacteria that can\u00a0cause more common diseases such as gonorrhea and salmonella. The goal is to spur governments to incentivize basic science and advance research and development, both public\u00a0and private sector, to invest in new antibiotic discovery. The list does not include tuberculosis, which does have increasing resistance, but is covered by other programs.<\/p>\n

Priority 1: critical<\/p>\n

    \n
  1. Acinetobacter baumanii, carbapenem-resistant<\/li>\n
  2. Pseudomonas aeruginosa, carbapenem-resistant<\/li>\n
  3. Enterobacteriaceae, carbapenem-resistant, ESBL-producing<\/li>\n<\/ol>\n

    Priority 2: high<\/p>\n

      \n
    1. Enterococcus faecium, vancomycin-resistant<\/li>\n
    2. Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant<\/li>\n
    3. Helicobacter pylori, clarithromycin-resistant [see\u00a0https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/category\/gi-h-pylori\/<\/a>\u200b for multiple blogs on H Pylori resistance and optimal treatment strategies]<\/li>\n
    4. Campylobacter spp., fluoroquinolone-resistant<\/li>\n
    5. Salmonellae, fluoroquinolone resistant<\/li>\n
    6. Neisseria gonorrheae, cephalosporin-resistant, fluoroquinolone-resistant<\/li>\n<\/ol>\n

      Priority 3: medium<\/p>\n

        \n
      1. Streptococcus pneumoniae, penicillin-non-susceptible<\/li>\n
      2. Haemophilus influenzae, ampicillin-resistant<\/li>\n
      3. Shigella spp., fluoroquinolone-resistant<\/li>\n<\/ol>\n

        Commentary:<\/p>\n