Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2011
Antimicrobial susceptibility of Gram-negative organisms from intraabdominal infections and evolution of isolates with extended spectrum β-lactamases in the SMART study in Spain (2002-2010).
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Cantón Rafael, Loza Elena, Aznar Javier, Calvo Jorge, Cercenado Emilia, Cisterna Ramón, Romo Fernando González, Hontangas José Luis López, Calvo Carmen Rubio, Barrenechea Ana Isabel Suárez, Tubau Fe, Weber Irene, Yuste Patricia, Cavanillas Rafael, SMART-Spain Working Group
Аннотация
INTRODUCTION: The SMART (Study for Monitoring Antimicrobial Resistance Trends) surveillance study records the antimicrobial susceptibility of Gram-negative bacilli obtain from intraabdominal infections with special focus in isolates with extended spectrum β-lactamases (ESBLs).
MATERIAL AND METHODS: The antimicrobial susceptibility of 8,869 isolates was analyzed by microdilution during the SMART study performed in Spain from 2002 to 2010. Isolates were recovered in 16 centres.
RESULTS: Escherichia coli was the most prevalent pathogen (60.9% from intraabdominal infections acquired in the community and 49.9% in those from nosocomial origin) followed by Klebsiella pneumoniae (8.9% vs 9.2%). Pseudomonas aeruginosa was more common in intraabdominal infections from nosocomial origin (5.6% community and 8.6% nosocomial). Frequency of ESBL-producing isolates was: E. coli, 8.7%; K. pneumoniae, 8.4%; Klebsiella oxytoca, 1.4%; and Proteus mirabilis, 1.6%. Overall, ESBL-producing isolates were more frequently isolated from elderly patients (6.8% >60 years). Ertapenem and meropenem were the most active antimicrobials (susceptibility range with EUCAST criteria, 89.0-100%) when considering all Enterobacteriaceae isolates and also against ESBL producers (95.5-100%). Susceptibility of amoxicillin/clavulanic acid and piperacillin/tazobactam was lower, particularly among ESBL-producing isolates. Nevertheless, ertapenem maintained a good activity (susceptibility >95%) in ESBL-producers that were resistant to amoxicillin/clavulanic acid, piperacillin/tazobactam or fluoroquinolones.
CONCLUSIONS: Antimicrobial susceptibility data from the SMART-Spain study reinforce current therapeutic guidelines of intraabdominal infections that include ertapenem as the empirical choice for treatment. This is also supported by the high frequency of ESBL-producers in our geographic area.
MATERIAL AND METHODS: The antimicrobial susceptibility of 8,869 isolates was analyzed by microdilution during the SMART study performed in Spain from 2002 to 2010. Isolates were recovered in 16 centres.
RESULTS: Escherichia coli was the most prevalent pathogen (60.9% from intraabdominal infections acquired in the community and 49.9% in those from nosocomial origin) followed by Klebsiella pneumoniae (8.9% vs 9.2%). Pseudomonas aeruginosa was more common in intraabdominal infections from nosocomial origin (5.6% community and 8.6% nosocomial). Frequency of ESBL-producing isolates was: E. coli, 8.7%; K. pneumoniae, 8.4%; Klebsiella oxytoca, 1.4%; and Proteus mirabilis, 1.6%. Overall, ESBL-producing isolates were more frequently isolated from elderly patients (6.8% >60 years). Ertapenem and meropenem were the most active antimicrobials (susceptibility range with EUCAST criteria, 89.0-100%) when considering all Enterobacteriaceae isolates and also against ESBL producers (95.5-100%). Susceptibility of amoxicillin/clavulanic acid and piperacillin/tazobactam was lower, particularly among ESBL-producing isolates. Nevertheless, ertapenem maintained a good activity (susceptibility >95%) in ESBL-producers that were resistant to amoxicillin/clavulanic acid, piperacillin/tazobactam or fluoroquinolones.
CONCLUSIONS: Antimicrobial susceptibility data from the SMART-Spain study reinforce current therapeutic guidelines of intraabdominal infections that include ertapenem as the empirical choice for treatment. This is also supported by the high frequency of ESBL-producers in our geographic area.
Предметные рубрики MeSH
AbdomenAdultAge FactorsAgedCross InfectionDrug Resistance, BacterialDrug Resistance, Multiple, BacterialEnterobacteriaceae InfectionsEnvironmental MonitoringEpidemiological MonitoringEscherichia coli InfectionsFemaleFollow-Up StudiesGram-Negative Aerobic BacteriaGram-Negative Anaerobic BacteriaGram-Negative BacteriaGram-Negative Bacterial InfectionsHumansKlebsiella InfectionsKlebsiella pneumoniaeMaleMicrobial Sensitivity TestsMiddle AgedSpainbeta-Lactamases