Journal article
Antimicrobial susceptibility patterns for pathogens isolated from patients in Latin American medical centers with a diagnosis of pneumonia: analysis of results from the SENTRY Antimicrobial Surveillance Program (1997)
Diagnostic microbiology and infectious disease, Vol.32(4), pp.289-301
1998
DOI: 10.1016/S0732-8893(98)00124-2
PMID: 9934546
Abstract
Pneumonia is the most common fatal hospital-acquired infection, with attributable mortality rates ranging from 30 to 60%. Rapid initiation of optimal antimicrobial therapy is essential for obtaining treatment success. In this report the antimicrobial susceptibility of 556 strains from the lower respiratory tract were collected by the SENTRY Antimicrobial Surveillance Program (1997). These strains were isolated from hospitalized patients with pneumonia in 10 Latin American centers (6 countries) as part of this 68-center worldwide program. The isolates were susceptibility tested against more than 70 drugs (35 reported) by the reference broth microdilution method.
Klebsiella pneumoniae and
Escherichia coli phenotypically consistent with extended spectrum β-lactamase (ESBL) production were characterized further by ribotyping and pulsed-field gel electrophoresis. The five most frequently isolated species were (n/%):
Pseudomonas aeruginosa (149/26.8%),
Staphylococcus aureus (127/22.8%),
Acinetobacter spp. (66/11.9%),
Klebsiella spp. (56/10.1%), and
Enterobacter spp. (40/7.2%).
P. aeruginosa demonstrated high rates of resistance to a majority of the antimicrobial drugs tested. Carbapenems, amikacin, and piperacillin/tazobactam demonstrated the highest susceptibility rates (73.8–77.2%) against
P. aeruginosa, however the lowest resistance rate was observed for cefepime (6.7%).
Acinetobacter spp. also showed very high rates of resistance and the most active compounds were imipenem and meropenem (89.0% susceptibility) followed by the tetracyclines. Cephalosporin susceptibilities among
Klebsiella spp. were low: cefoxitin, 73.0%; ceftazidime, 69.4%; and ceftriaxone, 65.9%. Approximately 37% and 28% of
K. pneumoniae and
E. coli isolates, respectively, were considered ESBL producers based on NCCLS criteria. Ceftriaxone was active against only 52.5% of
Enterobacter spp. isolates, whereas cefepime was active against 90.0% of isolates (MIC50, ≤0.12 μg/mL). Oxacillin resistance was detected in nearly 50% of
S. aureus isolates. The most active drugs against
S. aureus were vancomycin, teicoplanin, and quinupristin/dalfopristin (MIC90, 1 μg/mL). In summary, our study of pneumonias in Latin American medical centers demonstrated a greatly increased prevalence of
Acinetobacter spp. and higher resistance rates among Gram-negative bacilli when compared with similar controlled studies from North America.
Details
- Title: Subtitle
- Antimicrobial susceptibility patterns for pathogens isolated from patients in Latin American medical centers with a diagnosis of pneumonia: analysis of results from the SENTRY Antimicrobial Surveillance Program (1997)
- Creators
- Helio S Sader - Laboratório Especial de Microbiologia Clinica, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, Brazil (HSS, SENTRY)Ronald N Jones - Medical Microbiology Division (RNJ, ACG, PW, KCK, MAP, GVD), Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa, USAAna C Gales - Medical Microbiology Division (RNJ, ACG, PW, KCK, MAP, GVD), Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa, USAP Winokur - Medical Microbiology Division (RNJ, ACG, PW, KCK, MAP, GVD), Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa, USAKari C Kugler - Medical Microbiology Division (RNJ, ACG, PW, KCK, MAP, GVD), Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa, USAMichael A Pfaller - Medical Microbiology Division (RNJ, ACG, PW, KCK, MAP, GVD), Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa, USAGary V Doern - Medical Microbiology Division (RNJ, ACG, PW, KCK, MAP, GVD), Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa, USASENTRY Latin America Study Group
- Resource Type
- Journal article
- Publication Details
- Diagnostic microbiology and infectious disease, Vol.32(4), pp.289-301
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0732-8893(98)00124-2
- PMID
- 9934546
- ISSN
- 0732-8893
- eISSN
- 1879-0070
- Language
- English
- Date published
- 1998
- Academic Unit
- Infectious Diseases; Epidemiology; Pathology; Medicine Administration; Internal Medicine
- Record Identifier
- 9984094480802771
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