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Medientyp:
E-Artikel
Titel:
Antimicrobial Resistance among Gram-Negative Bacilli Causing Infections in Intensive Care Unit Patients in the United States between 1993 and 2004
Beteiligte:
Lockhart, Shawn R.;
Abramson, Murray A.;
Beekmann, Susan E.;
Gallagher, Gale;
Riedel, Stefan;
Diekema, Daniel J.;
Quinn, John P.;
Doern, Gary V.
Erschienen:
American Society for Microbiology, 2007
Beschreibung:
<jats:title>ABSTRACT</jats:title>
<jats:p>
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
<jats:italic>Pseudomonas aeruginosa</jats:italic>
(22.2%),
<jats:italic>Escherichia coli</jats:italic>
(18.8%),
<jats:italic>Klebsiella pneumoniae</jats:italic>
(14.2%),
<jats:italic>Enterobacter cloacae</jats:italic>
(9.1%),
<jats:italic>Acinetobacter</jats:italic>
spp. (6.2%),
<jats:italic>Serratia marcescens</jats:italic>
(5.5%),
<jats:italic>Enterobacter aerogenes</jats:italic>
(4.4%),
<jats:italic>Stenotrophomonas maltophilia</jats:italic>
(4.3%),
<jats:italic>Proteus mirabilis</jats:italic>
(4.0%),
<jats:italic>Klebsiella oxytoca</jats:italic>
(2.7%), and
<jats:italic>Citrobacter freundii</jats:italic>
(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.
<jats:italic>E. coli</jats:italic>
and
<jats:italic>P. mirabilis</jats:italic>
remained susceptible to most of the drugs tested. Mean rates of resistance to 9 of the 12 drugs tested increased with
<jats:italic>Acinetobacter</jats:italic>
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 (
<jats:italic>Acinetobacter</jats:italic>
spp.,
<jats:italic>C. freundii</jats:italic>
,
<jats:italic>E. aerogenes</jats:italic>
,
<jats:italic>K. pneumoniae</jats:italic>
,
<jats:italic>P. aeruginosa</jats:italic>
, and
<jats:italic>S. marcescens</jats:italic>
) 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
<jats:italic>Acinetobacter</jats:italic>
spp.,
<jats:italic>P. aeruginosa</jats:italic>
,
<jats:italic>K. pneumoniae</jats:italic>
, and
<jats:italic>E. cloacae</jats:italic>
.
</jats:p>