Nosocomial infections are commonly associated with invasive medical devices or surgical procedures. The emergence of multi-drug resistance organisms particularly the Gram-negative bacteria creates a challenge in the treatment of nosocomial infections. The emergence of multidrug-resistant (MDR) Gram-negative bacteria in the healthcare is a serious concern. Compounding the problem of antimicrobial resistance is the immediate threat of a reduction in the
discovery and development of new antibiotics. Recent clinical attention has focused on the increasing frequency of Gram –negative pathogens responsible for hospital acquired infections (HAIs), e.g. extended- spectrum β-lactamase
(ESBL) and carbapenemase producing Enterobacteriaceae, in particular A. baumannii have caused major challenges recently. The treatment options have been limited to two revived old antibacterial (colistin and fosfomycin), a newer one (tigecyclin) and an improved of an existing class (doripenem) are the therapeutic left. The multi-factorial causes of nosocomial infections has to be addressed, inclusive of the use of antibiotics in animals as wells in humans.