FRIEDLAND I, WOODS G, SATISHCHANDRAN V; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. C2-189.
Merck Research Laboratories, West Point, PA.
BACKGROUND: SMART (Study for Monitoring Antimicrobial Resistance Trends) is an ongoing global antimicrobial surveillance study, initiated in 2002, that is unique in its focus on IAI, most of which are community-acquired. The objective of this study is to assess antimicrobial susceptibility among Enterobacteriaceae causing IAI. Regional results may be useful locally for guiding therapy. METHODS: In 2002, 10 centers in the US and 9 in Asia tested the activity of 12 antimicrobials commonly used to treat IAI against 100 consecutive nonduplicate aerobic gram-negative bacilli isolated from intra-abdominal specimens, by microdilution following NCCLS guidelines. Enterobacteriaceae are reported here. RESULTS: 632 Enterobacteriaceae in the US and 663 in Asia were tested. For all Enterobacteriaceae, resistance to carbapenems was = 1% in both regions. Of the 7 ertapenem-resistant strains from Asia, 3 were resistant to imipenem, 2 were resistant and 3 were intermediate to meropenem. For other agents % susceptibility, US v Asia, was: amikacin 98 v 95, cefepime 97 v 90, tobramycin (TBR) 94 v 77, piperacillin-tazobactam 93 v 92, ceftazidime (CTZ) 93 v 84, ceftriaxone (CRO) 92 v 80, ciprofloxacin (CPR) 92 v 74, ampicillin-sulbactam (A/S) 66 v 48. In the US and Asia, respectively, 11/340 (3%) & 57/330 (17%) E. coli & 5/132 (4%) & 35/183 (19%) Klebsiella produced an extended-spectrum b -lactamase (ESBL); 23/69 (33%) & 20/46 (44%) Enterobacter were CTZ resistant. CONCLUSION: In the US, many agents used to treat IAI retain useful activity against Enterobacteriaceae; A/S is an exception. In Asia, susceptibility to CPR, CTZ, CRO and TBR was markedly lower than in the US. ESBL+ strains of E. coli and Klebsiella were relatively uncommon in these predominantly community-acquired IAI in the US but approached 20% in Asian isolates. CTZ resistant Enterobacter were common in both regions. Carbapenems remain the most active agents against Enterobacteriaceae, including strains resistant to other antimicrobials.>
Publication Types:
Keywords:
- Ampicillin
- Anti-Infective Agents
- Asia
- Bacteria
- Carbapenems
- Cephalosporins
- Cross Infection
- Enterobacter
- Enterobacteriaceae
- Enterobacteriaceae Infections
- Gram-Negative Bacteria
- Imipenem
- Infection
- Klebsiella
- Klebsiella pneumoniae
- Lactams
- Sulbactam
- beta-Lactamases
- cefepime
- ertapenem
- sultamicillin
Other ID:
UI: 102266153
From Meeting Abstracts