The term MDR-GNB is used in different ways by clinicians and researchers to describe a range of Gram-negative pathogens with resistant characteristics (e.g. ESBLs, CRE or resistance to specific antibiotics). This can lead to confusion when interpreting data from studies that report colonization and/or infection rates. Additionally, bacterial definitions vary widely from one study to the next and may not include information on antibiotic susceptibility or resistance determinants.

This article provides a brief overview of MDR-GNB, and describes different approaches to assessing MDR-GNB colonization, including screening methods, transmission-based precautions and infection control interventions. It highlights the importance of a tailored approach for managing MDR-GNB in a specific setting (e.g. NICU) with practices adapted to the clinical context.

Understanding MRGN 101: A Beginner’s Guide to Margin

Infection with MDR-GNB has been linked to increased morbidity and mortality, especially in infants born prematurely or with underlying medical conditions. High rates of MDR-GNB colonization and infection, especially with ESBL-producing Enterobacteriaceae and CRE, in LMICs and the occasional outbreak in high income countries have raised concern about the public health impact. In the case of neonatal MDR-GNB, high rates of emergence and resistance mean that appropriate treatment options are limited. Infection control in NICUs is challenging and requires multidisciplinary teams, including infectious diseases and pediatricians. MRGN 101 aims to assist healthcare professionals in understanding and implementing current CDC recommendations for screening, infection control and management of patients infected or colonized with MDR-GNB.