Emerging resistance among bacterial pathogens in the intensive care unit - A European and North American surveillance study (2000-2002)

被引：58

作者：

Jones M.E. ^{[1
]}

Draghi D.C. ^{[1
]}

Thornsberry C. ^{[1
]}

Karlowsky J.A. ^{[1
]}

Sahm D.F. ^{[1
]}

Wenzel R.P. ^{[2
]}

机构：

[1] Focus Technologies, Herndon

[2] Virginia Commonwealth University, Richmond, VA

来源：

Annals of Clinical Microbiology and Antimicrobials | / 3卷 / 1期

关键词：

Antibiotic susceptibility; Intensive-care unit;

D O I：

10.1186/1476-0711-3-14

中图分类号：

学科分类号：

摘要：

Background: Globally ICUs are encountering emergence and spread of antibiotic-resistant pathogens and for some pathogens there are few therapeutic options available. Methods: Antibiotic in vitro susceptibility data for predominant ICU pathogens during 2000-2 were analyzed using data from The Surveillance Network (TSN) Databases in Europe (France, Germany and Italy), Canada, and the United States (US). Results: Oxacillin resistance rates among Staphylococcus aureus isolates ranged from 19.7% to 59.4%. Penicillin resistance rates among Streptococcus pneumoniae varied from 2.0% in Germany to as high as 20.2% in the US; however, ceftriaxone resistance rates were comparably lower, ranging from 0% in Germany to 3.4% in Italy. Vancomycin resistance rates among Enterococcus faecalis were ≤ 4.5%; however, among Enterococcus faecium vancomycin resistance rates were more frequent ranging from 0.8% in France to 76.3% in United States. Putative rates of extended-spectrum β-lactamase (ESBL) production among Enterobacteriaceae were low, <6% among Escherichia coli in the five countries studied. Ceftriaxone resistance rates were generally lower than or similar to piperacillin-tazobactam for most of the Enterobactariaceae species examined. Fluoroquinolone resistance rates were generally higher for E coli (6.5% - 13.9%), Proteus mirabilis (0-34.7%), and Morganella morganii (1.6-20.7%) than other Enterobacteriaceae spp (1.5-21.3%). P. aeruginosa demonstrated marked variation in β-lactam resistance rates among countries. Imipenem was the most active compound tested against Acinetobacter spp., based on resistance rates. Conclusion: There was a wide distribution in resistance patterns among the five countries. Compared with other countries, Italy showed the highest resistance rates to all the organisms with the exception of Enterococcus spp., which were highest in the US. This data highlights the differences in resistance encountered in intensive care units in Europe and North America and the need to determine current local resistance patterns by which to guide empiric antimicrobial therapy for intensive care infections. © 2004 Jones et al; Licensee BioMed Central Ltd.

引用

页数：11

共 26 条

[1]

Kollef M.H., Fraser V.J., Antibiotic resistance in the Intensive Care Unit, Ann. Intern. Med., 134, pp. 298-314, (2001)

[2]

National nosocomial infections surveillance (NNIS) system report, data summary from January 1992-April issued August 2001, Amer. J. Infect. Contr., 29, pp. 400-421, (2001)

[3]

NNIS system report Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Surveillance report, data summary from January 1996 through December 1997, Amer. J. Infect. Contr., 27, pp. 279-284, (1999)

[4]

Fridkin S.K., Steward C.D., Edwards J.R., Pryor E.R., McGowan J.E., Archibald L.K., Gaynes R.P., Tenover F.C., Surveillance of antimicrobial use and antimicrobial resistance in United States hospitals: Project ICARE Phase 2. Project Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Hospitals, Clin. Infec. Dis., 29, pp. 245-252, (1999)

[5]

Stephen J., Mutnick A., Jones R.N., Assessment of pathogens and resistance (R) patterns among intensive care unit (ICU) in North America (NA): Initial report from the SENTRY antimicrobial surveillance program (2001), (2002)

[6]

Vincent J.L., Bihari D.J., Suter P.M., Bruining H.A., White J., Nicloas-Chaoin M.H., Wolff M., Spencer R.C., Hemmer M., The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study, J. Amer. Med. Assoc., 274, pp. 639-644, (1995)

[7]

Hanberger H., Garcia-Rodriguez J.A., Gobernado M., Et al., Antibiotic susceptibility among aerobic Gram-negative bacilli in Intensive Care Units in 5 European countries, JAMA, 281, pp. 67-71, (1999)

[8]

Garcia-Rodriguez J.A., Jones R.N., Antimicrobial resistance in gram-negative isolates from European intensive care units: Data from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) programme, J. Chem., 14, pp. 25-32, (2002)

[9]

Frank U., Jonas D., Lupke T., Ribeiro-Ayeh B., Schmidt-Eisenlohr E., Ruden H., Daschner F.D., Antimicrobial susceptibility among nosocomial pathogens isolated in intensive care units in Germany, Eur. J. Clin. Microbiol. Infect. Dis., 19, pp. 888-891, (2000)

[10]

Fiel S., Guidelines and critical pathways for severe hospital-acquired pneumonia, Chest, 119, (2001)

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