Monitoring the global in vitro activity of ertapenem against Escherichia coli from intra-abdominal infections: SMART 2002-2010.

During 2002-2010, a total of 30840 Escherichia coli clinical isolates from intra-abdominal infections were collected globally in the Study for Monitoring Antimicrobial Resistance Trends (SMART) surveillance programme. The incidence of extended-spectrum β-lactamase (ESBL)-producing isolates ranged from 9.2% in 2002 to 21.2% in 2010. The highest rates were observed in Asia (38.3%) and Latin America (22.9%) and the lowest rates in Africa (6.3%), North America (6%) and South Pacific (5.8%). Global susceptibility trends showed that there were only minor fluctuations in susceptibility to ertapenem and imipenem, with no significant decrease over time. Against ESBL-positive isolates, ertapenem susceptibility significantly increased during 2002-2010 globally. Moreover, susceptibility to ertapenem in the different geographical regions studied was also high, with only minor fluctuations generally observed. Notably, in Asia where the highest ESBL-positives rates (38.3%) were observed, susceptibility to ertapenem had actually significantly increased in this population during the 9-year study period. By contrast, susceptibility to amikacin, cephalosporins, fluoroquinolones and β-lactam/β-lactamase inhibitor combinations generally decreased over time. Further monitoring of the susceptibility to ertapenem and other antibiotics through SMART is warranted.