Review of the epidemiological data regarding antimicrobial resistance in Gram-negative bacteria in Australia

Abstract

Abstract Objective Antimicrobial resistance of Gram-negative bacilli (GNB) presents a challenge for medical practice, however relatively little is known of its impact within the community of hospital setting. We aimed to present the strengths and weaknesses of the current literature of resistant GNB strains in Australia. Method A review was undertaken of published and grey literature reporting Australian data on drug-resistant GNB between the years 1990 until February 2017. Results A total of 17 peer-reviewed publications were identified, the majority of these were national surveys designed to track proportions of resistance in clinical isolates. The remaining publications were largely single-site tertiary centre studies reporting frequencies of resistant compared to susceptible organisms and various combinations of antibiotic therapy, data which are necessary for clinical practice. Conclusion A limited evidence-base exists to inform changes in antimicrobial resistance at the population-level, and these data are needed. Only two studies were identified that quantified the impact of resistance on morbidity and mortality, albeit with statistical imperfections in the study design. More data, which are standardised using accepted definitions are needed to appropriately understand the health and economic impact of resistant GNB in Australia.