multidrugresistente

Multidrugresistente, often abbreviated as MDRO, is a term used to describe microorganisms that have acquired resistance to more than one class of antimicrobial agents. These pathogens can cause infections that are harder to treat, may require alternative therapies, and are associated with worse clinical outcomes. Common MDROs include methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-E), and carbapenem-resistant Enterobacteriaceae (CRE). Multidrug-resistant strains of Mycobacterium tuberculosis are referred to as MDR-TB, with extensively drug-resistant TB (XDR-TB) representing an even more resistant form. MDROs can also involve fungi such as Candida auris in certain settings.

Causes of multidrug resistance include genetic mutations and the acquisition of resistance genes through horizontal gene transfer. This resistance is driven by selective pressure from antimicrobial use in human medicine, animal husbandry, and agriculture. Risk factors include hospitalization, invasive procedures, prolonged antibiotic exposure, weakened immune systems, and residence in crowded facilities.

Clinical impact of MDRO infections includes longer hospital stays, higher treatment costs, increased morbidity and mortality, and limited options for effective therapy. Management often relies on susceptibility-guided, sometimes combination therapies, and may require specialist consultation.

Prevention and control focus on reducing unnecessary antibiotic use (antimicrobial stewardship), rigorous infection prevention and control (hand hygiene, contact precautions, patient isolation when indicated), environmental cleaning, and surveillance to identify carriers. Rapid diagnostics and coordinated public health efforts enhance detection and containment. MDROs remain a major global health challenge, underscoring the need for continued research, surveillance, and prudent antimicrobial use.