Resistência Antimicrobiana Em Bacilos Gram-negativos: Bases Biológicas, Repercussões Clínicas E Terapêuticas
Year: 2026
Type: book-chapter
Abstract: RESUMO: A resistência antimicrobiana em bacilos Gram-negativos constitui um importante problema de saúde pública, particularmente diante da emergência de fenótipos multirresistentes que restringem as alternativas terapêuticas.Este capítulo discute os bacilos Gram-negativos multirresistentes (BGN-MDR), integrando os fundamentos microbiológicos da resistência às suas implicações clínicas e terapêuticas.São abordados os principais mecanismos de resistência, incluindo alterações de ABSTRACT: Antimicrobial resistance in Gram-negative bacilli represents a major public health concern, particularly with the emergence of multidrug-resistant phenotypes that limit therapeutic options.This chapter discusses multidrug-resistant Gramnegative bacilli (MDR-GNB), integrating the microbiological foundations of resistance with their clinical and therapeutic implications.The main resistance mechanisms are addressed, including changes in membrane permeability and efflux, enzymatic inactivation, and modifications of cellular targets and lipopolysaccharide, as well as their contributions to different susceptibility profiles.The impact of multidrug resistance on therapy is discussed, emphasizing the importance of pathogen identification, antimicrobial susceptibility profiles, resistance mechanisms, infection site, and patient characteristics in guiding treatment.Therapeutic strategies for different MDR-GNB are also presented, alongside pharmacokinetic and pharmacodynamic principles for optimizing antimicrobial exposure.Finally, the rational use of antimicrobials and the role of antimicrobial stewardship programs are highlighted as essential components for optimizing pharmacotherapy, reducing unnecessary exposure, and preserving the effectiveness of available therapeutic options.
Institution: Universidade Federal da Grande Dourados
Language: Portuguese
Subfield: Microbiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W7222929796