Antimicrobial resistance among Gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004

Shawn R Lockhart; Murray A Abramson; Susan E Beekmann; Gale Gallagher; Stefan Riedel; Daniel J Diekema; John P Quinn; Gary V Doern

doi:10.1128/JCM.01284-07

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Antimicrobial resistance among Gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004

Journal article

Open access

Peer reviewed

Antimicrobial resistance among Gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004

Shawn R Lockhart, Murray A Abramson, Susan E Beekmann, Gale Gallagher, Stefan Riedel, Daniel J Diekema, John P Quinn and Gary V Doern

Journal of clinical microbiology, Vol.45(10), pp.3352-3359

10/2007

DOI: 10.1128/JCM.01284-07

PMCID: PMC2045364

PMID: 17715376

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Abstract

During the 12-year period from 1993 to 2004, antimicrobial susceptibility profiles of 74,394 gram-negative bacillus isolates recovered from intensive care unit (ICU) patients in United States hospitals were determined by participating hospitals and collected in a central location. MICs for 12 different agents were determined using a standardized broth microdilution method. The 11 organisms most frequently isolated were Pseudomonas aeruginosa (22.2%), Escherichia coli (18.8%), Klebsiella pneumoniae (14.2%), Enterobacter cloacae (9.1%), Acinetobacter spp. (6.2%), Serratia marcescens (5.5%), Enterobacter aerogenes (4.4%), Stenotrophomonas maltophilia (4.3%), Proteus mirabilis (4.0%), Klebsiella oxytoca (2.7%), and Citrobacter freundii (2.0%). Specimen sources included the lower respiratory tract (52.1%), urine (17.3%), and blood (14.2%). Rates of resistance to many of the antibiotics tested remained stable during the 12-year study period. Carbapenems were the most active drugs tested against most of the bacterial species. E. coli and P. mirabilis remained susceptible to most of the drugs tested. Mean rates of resistance to 9 of the 12 drugs tested increased with Acinetobacter spp. Rates of resistance to ciprofloxacin increased over the study period for most species. Ceftazidime was the only agent to which a number of species (Acinetobacter spp., C. freundii, E. aerogenes, K. pneumoniae, P. aeruginosa, and S. marcescens) became more susceptible. The prevalence of multidrug resistance, defined as resistance to at least one extended-spectrum cephalosporin, one aminoglycoside, and ciprofloxacin, increased substantially among ICU isolates of Acinetobacter spp., P. aeruginosa, K. pneumoniae, and E. cloacae.

United States

Gram-Negative Bacterial Infections - microbiology

Microbial Sensitivity Tests

Gram-Negative Bacteria - drug effects

Intensive Care Units

Time Factors

Cross Infection - microbiology

Drug Resistance, Multiple, Bacterial

Fluoroquinolones - pharmacology

Humans

Drug Resistance, Bacterial

Details

Title: Subtitle: Antimicrobial resistance among Gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004
Creators: Shawn R Lockhart - Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242-1009, USA. shawn-lockhart@uiowa.edu
Murray A Abramson
Susan E Beekmann
Gale Gallagher
Stefan Riedel
Daniel J Diekema
John P Quinn
Gary V Doern
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.45(10), pp.3352-3359
DOI: 10.1128/JCM.01284-07
PMID: 17715376
PMCID: PMC2045364
NLM abbreviation: J Clin Microbiol
ISSN: 0095-1137
eISSN: 1098-660X
Publisher: United States
Language: English
Date published: 10/2007
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986368302771

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