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Resistance in Enterobacteriaceae: Results of a Multicenter Surveillance Study, 1995-2000

Published online by Cambridge University Press:  02 January 2015

Ian Friedland ,
Lue Stinson ,
Margaretmary Ikaiddi ,
Sandra Harm  and
Gail L. Woods
Ian Friedland
Affiliation:
Merck Research Laboratories, West Point, Pennsylvania
Lue Stinson
Affiliation:
Merck Research Laboratories, West Point, Pennsylvania
Margaretmary Ikaiddi
Affiliation:
Merck Research Laboratories, West Point, Pennsylvania
Sandra Harm
Affiliation:
Merck Research Laboratories, West Point, Pennsylvania
Gail L. Woods*
Affiliation:
Merck Research Laboratories, West Point, Pennsylvania
*
Merck & Co., Inc., 10 Sentry Parkway, BL3-4, Blue Bell, PA 19422
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Abstract

Objectives:

To assess changes over time in susceptibility of Enterobacteriaceae from patients in ICUs, compare susceptibility rates of isolates from patients in ICUs with those from inpatients outside ICUs, and explore phenotypic patterns of cross-resistance and co-resistance.

Design:

From 1995 to 2000, centers participating in the ICU Surveillance Study tested 100 to 200 consecutive nosocomial gram-negative bacilli by broth microdilution.

Setting:

Each year, 42 to 97 U.S. hospitals tested isolates.

Results:

In all years, imipenem was the most potent agent tested, followed by amikacin and ertapenem. Extended-spectrum beta-lactam and monobactam agents had good activity against Escherichia coli and Klebsiella species, but limited activity against Enterobacter species. Susceptibility to imipenem and amikacin did not fluctuate during the analysis period, whereas susceptibility to ceftazidime, ceftriaxone, and ciprofloxacin decreased 2% to 5%. The decline was most pronounced for susceptibility of Escherichia coli to ciprofloxacin: 98.7% of ICU isolates were susceptible in 1995 versus 93.2% in 2000. Susceptibility of ICU isolates was lower than that of non-ICU isolates, except for ciprofloxacin, for which the reverse was true. Cross-resistance was common among extended-spectrum cephalosporins and penicillins, but uncommon between imipenem and ertapenem. Only imipenem and ertapenem remained highly active against Enterobacteriaceae with a phenotype suggesting possible production of an extended-spectrum beta-lactamase and those with a phenotype suggesting possible Amp C hyperproduction.

Conclusions:

Imipenem was the most active agent against nosocomial Enterobacteriaceae. Susceptibility to ciprofloxacin decreased from 1995 to 2000, particularly in Escherichia coli, and, in contrast to other agents, was lower among non-ICU isolates.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 8 , August 2003 , pp. 607 - 612
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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References

1.Ibrahim, EH, Sherman, G, Ward, S, et al.The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest 2000;118:146–155.Google Scholar
2.Kollef, MH, Sherman, G, Ward, S, et al.Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest 1999;115:462–474.Google Scholar
3.Paterson, DL, Mulazimoglu, L, Casellas, JM, et al.Epidemiology of ciprofloxacin resistance and its relationship to extended-spectrum β-lactamase production in Klebsiella pneumoniae isolates causing bacteremia. Clin Infect Dis 2000;30:473–478.Google Scholar
4.Kim, Y-K, Pai, H, Lee, H-J, et al.Bloodstream infections by extended-spectrum ß-lactamase producing Escherichia coli and Klebsiella pneumoniae in children: epidemiology and clinical outcome. Antimicrob Agents Chemother 2002;46:1481–1491.CrossRefGoogle Scholar
5.Kaye, KS, Cosgrove, S, Harris, A, et al.Risk factors for emergence of resistance to broad-spectrum cephalosporins among Enterobacter spp. Antimicrob Agents Chemother 2001;45:2628–2630.CrossRefGoogle ScholarPubMed
6.National Committee for Clinical Laboratory Standards. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically, 5th ed. Wayne, PA: National Committee for Clinical Laboratory Standards; 2000. Document M7-A5.Google Scholar
7.National Committee for Clinical Laboratory Standards. Performance Standard for Antimicrobial Susceptibility Testing. Wayne, PA: National Committee for Clinical Laboratory Standards; 2002. Document M100-S12.Google Scholar
8.Diekema, DJ, Pfaller, MA, Jones, RN, et al.Survey of bloodstream infections due to gram-negative bacilli: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, and Latin America for the SENTRY Antimicrobial Surveillance Program, 1997. Clin Infect Dis 1999;29:595–607.Google Scholar
9.Pfaller, MA, Jones, RN, Biedenbach, DJ, et al.Antimicrobial resistance trends in medical centers using carbapenems: report of 1999 and 2000 results from the MYSTIC Program (USA). Diagn Microbiol Infect Dis 2001;41:177–182.Google Scholar
10.Karlowsky, JA, Kelly, LJ, Thornsberry, C, et al.Susceptibility to fluoroquinolones among commonly isolated gram-negative bacilli in 2000: TRUST and TSN data for the United States. Int J Antimicrob Agents 2002;19:21–31.CrossRefGoogle ScholarPubMed
11.Garcia-Rodriguez, J-A, Jones, RN, MYSTIC Programme Study Group. Antimicrobial resistance in gram-negative isolates from European intensive care units: data from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme. J Chemother 2002;14:25–32.Google Scholar
12.Ahmad, M, Urban, C, Mariano, N, et al.Clinical characteristics and molecular epidemiology associated with imipenem-resistant Klebsiella pneumoniae. Clin Infect Dis 1999;29:352–355.Google Scholar
13.Itokazu, GS, Quinn, JP, Bell-Dixon, C, et al.Antimicrobial resistance rates among aerobic gram-negative bacilli recovered from patients in intensive care units: evaluation of a national postmarketing surveillance program. Clin Infect Dis 1996;23:779–784.Google Scholar
14.Fridkin, SK, Hill, HA, Volkova, NV, et al.Temporal changes in prevalence of antimicrobial resistance in 23 U.S. hospitals. Emerg Infect Dis 2002;8:697–701.CrossRefGoogle Scholar
15.Goettsch, W, van Pelt, W, Nagelkerke, N, et al.Increasing resistance to fluoroquinolones in Escherichia coli from urinary tract infections in the Netherlands. J Antimicrob Chemother 2000;46:223–228.Google Scholar
16.Livermore, DM, James, D, Reacher, M, et al.Trends in fluoroquinolone (ciprofloxacin) resistance in Enterobacteriaceae from bacteremias, England and Wales, 1990-1999. Emerg Infect Dis 2002;8:473–478.CrossRefGoogle ScholarPubMed
17.Pfaller, MA, Jones, RN, MYSTIC Study Group (Europe). Antimicrobial susceptibility of inducible AmpC ß-lactamase-producing Enterobacteriaceae from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme, Europe 1997-2000. Int J Antimicrob Agents 2002;19:383–388.Google Scholar
18.Fridkin, SK, Steward, CD, Edwards, JR, et al.Surveillance of antimicrobial use and antimicrobial resistance in United States hospitals: Project ICARE phase 2. Clin Infect Dis 1999;29:245–252.Google Scholar
19.Chow, JW, Fine, MJ, Shlaes, DM, et al.Enterobacter bacteremia: clinical features and emergence of antibiotic resistance during therapy. Ann Intern Med 1991;115:585–590.Google Scholar
20.Cosgrove, SE, Kaye, KS, Eliopoulous, GM, Carmeli, Y. Health and economic outcomes of the emergence of third-generation cephalosporin resistance in Enterobacter species. Arch Intern Med 2002;162:185–190.CrossRefGoogle ScholarPubMed