Journal article
Characteristics of pathogens causing urinary tract infections in hospitals in North America: results from the SENTRY Antimicrobial Surveillance Program, 1997
Diagnostic microbiology and infectious disease, Vol.35(1), pp.55-63
1999
DOI: 10.1016/S0732-8893(98)00158-8
PMID: 10529882
Abstract
Urinary tract infection (UTI) is common and involves pathogens with changing susceptibility patterns. The SENTRY Antimicrobial Surveillance Program evaluates international pathogen incidence patterns to detect and manage the emergence of resistant strains. We describe the antimicrobial resistance patterns among 1617 pathogens recovered from UTIs during the third-quarter of 1997 in North America (United States and Canada), as part of this worldwide program. The isolates were tested against more than 50 antimicrobial agents (20 reported) by reference broth microdilution methods, and selected isolates were characterized by pulsed-field gel electrophoresis (PFGE) and automated ribotyping. The five most frequently isolated species were
Escherichia coli (48.6%),
Enterococcus spp. (13.7%),
Klebsiella spp. (12.0%),
Pseudomonas aeruginosa (6.2%), and
Enterobacter spp. or
Proteus mirabilis (3.8% each). For each nation, imipenem and cefepime produced the widest spectrum of coverage among the β-lactams and amikacin was best among the aminoglycosides. For Gram-negative species, high resistance among β-lactam antimicrobial agents was noted especially for various penicillins against
E. coli (37.9% to 42.8%) and for the cephalosporins tested against enterococci (99.4% and 100%). Approximately 7.0% of enterococci in the USA were vancomycin-resistant (88% with
Van A).
P. aeruginosa provided the most consistent levels of resistance, but the following agents were most active against these organisms: amikacin (96.6 to 97.4% susceptible), tobramycin (89.5 to 100.0%), piperacillin/tazobactam (89.5 to 100.0%), piperacillin (89.5 to 96.6%), imipenem (89.7 to 92.1%), cefepime (77.6 to 89.7%), and ceftazidime (82.9 to 86.2%).
E. coli (2.2 to 2.7%),
K. pneumoniae (6.2 to 6.4%), and a single
Enterobacter cloacae strain produced extended-spectrum β-lactamases; and five other
Enterobacter spp. were likely to have expressed chromosomally mediated (
Amp C) stably derepressed cephalosporinases with associated resistance to ceftazidime (16.7 to 21.2% resistance). These data demonstrated that several UTI isolates in SENTRY hospitals have high levels of resistance to various classes of antimicrobial agents with little evidence of clonal dissemination.
Details
- Title: Subtitle
- Characteristics of pathogens causing urinary tract infections in hospitals in North America: results from the SENTRY Antimicrobial Surveillance Program, 1997
- Creators
- Ronald N Jones - Medical Microbiology Division, University of Iowa College of Medicine, Iowa City, Iowa, USAKari C Kugler - Medical Microbiology Division, University of Iowa College of Medicine, Iowa City, Iowa, USAMichael A Pfaller - Medical Microbiology Division, University of Iowa College of Medicine, Iowa City, Iowa, USAPatricia L Winokur - Medical Microbiology Division, University of Iowa College of Medicine, Iowa City, Iowa, USASENTRY Surveillance Group North America
- Resource Type
- Journal article
- Publication Details
- Diagnostic microbiology and infectious disease, Vol.35(1), pp.55-63
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0732-8893(98)00158-8
- PMID
- 10529882
- ISSN
- 0732-8893
- eISSN
- 1879-0070
- Language
- English
- Date published
- 1999
- Academic Unit
- Infectious Diseases; Epidemiology; Pathology; Medicine Administration; Internal Medicine
- Record Identifier
- 9984094627502771
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