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Results from a recent surveillance programme in the US and Europe, indicate that spp., accounts for an average of 6.5% of all Gram negative infection in Intensive Care Units (ranked 5th amongst Gram negative organisms in ICU) and an average of 3.5% in non-ICU patients (91).Currently is the seventh most common cause of pneumonia with an incidence of 4.1% in the US, 3.2% in Europe and 2.4% in Latin America (51), and the tenth most common cause of bloodstream infection with an incidence of 2.0% amongst hospitalized patients (2).is implicated in a wide range of serious infections including pneumonia (51), lower respiratory tract infection (112), urinary tract infection (53), bloodstream infection, wound infection and meningitis (72, 74).

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is rarely associated with primary invasive infection.

It operates as a true opportunist producing infection whenever it gains access to a suitably compromised host.

In one hospital, almost 50% of hand cultures from staff were positive at the end of their working shift (113).

Factors such as debilitating clinical condition, lengthy ward-stay and frequent exposure to medical interventions, most likely act by necessitating increased frequency and intensity of direct contact with staff hands (111).

Early studies reported that more than 97% of isolates were susceptible to gentamicin at 1 µg/ml or less (119). Patient factors contributing to the emergence of gentamicin-resistant Serratia marcescens. Determination of the pharmacodynamic activity of clinically achievable tigecycline serum concentrations against clinical isolates of Escherichia coli with extended-spectrum beta-lactamases, Amp C beta-lactamases and reduced susceptibility to carbapenems using an in vitro model. [Pub Med] Effective treatment option where resistance to third-generation cephalosporins is evident or likely to develop.

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