Epidemiology and Susceptibility of Gram-Negative Appendicitis Pathogens: SMART 2008–2010
| Autor: | Sibylle H. Lob, Meredith Hackel, Stephen Hawser, Daryl J. Hoban, Samuel K. Bouchillon, Robert E. Badal |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Microbiology (medical) medicine.medical_specialty Bacilli Klebsiella pneumoniae Microbial Sensitivity Tests Global Health Microbiology Cohort Studies chemistry.chemical_compound Antibiotic resistance Drug Resistance Bacterial Gram-Negative Bacteria Epidemiology medicine Humans Public Health Surveillance Child biology business.industry Broth microdilution Appendicitis biology.organism_classification medicine.disease Proteus mirabilis Anti-Bacterial Agents Infectious Diseases chemistry Epidemiological Monitoring Surgery Gram-Negative Bacterial Infections business Ertapenem |
| Zdroj: | Surgical Infections. 14:203-208 |
| ISSN: | 1557-8674 1096-2964 |
| DOI: | 10.1089/sur.2012.034 |
| Popis: | The Study for Monitoring Antimicrobial Resistance Trends (SMART) has tracked the in vitro activity of ertapenem and comparators against aerobic gram-negative bacteria from intra-abdominal infections since 2002. This report describes the epidemiology and susceptibility for clinical isolates associated with appendicitis, collected from 2008 to 2010.A total of 1,720 gram-negative bacilli were collected from patients with appendicitis in 122 hospitals in 39 countries worldwide; of these, 23% of isolates were from pediatric patients (≤ 17 years old). Minimum inhibitory concentrations (MICs) and extended-spectrum β-lactamase (ESBL) phenotypes were determined by broth microdilution and interpreted using Clinical and Laboratory Standards Institute guidelines.The global ESBL-positive rate was 16.3%, ranging from 2.2% for Proteus mirabilis to 16.6% for Escherichia coli and 20.1% for Klebsiella pneumoniae. The ESBL-positive rates differed by age group (17.7% in adults vs. 11.4% in children) and by geographic region, with significantly higher rates in Asia/Pacific (28.0%) and significantly lower rates in North America (9.1%), Africa/Middle East (4.8%), and Europe (4.4%). Amikacin, imipenem-cilastatin, piperacillin-tazobactam, and ertapenem were the most active of the tested agents against aerobic gram-negative appendicitis pathogens across pediatric and adult age groups and across geographic regions, including ESBL-positive isolates. Cefepime and ceftazidime were active against ≥ 90% of global pediatric isolates. E. coli, by far the most frequently isolated species (68% in adults and 75% in pediatric patients), was significantly less susceptible in adults than in pediatric patients (p0.05; Fisher exact test) to all tested agents except amikacin, ertapenem, imipenem-cilastatin, piperacillin-tazobactam, and ampicillin-sulbactam (with the latter showing low activity in both age groups).These in vitro data suggest that amikacin, imipenem-cilastatin, piperacillin-tazobactam, and ertapenem would perform well against aerobic gram-negative bacilli associated with appendicitis in both adults and children, especially in regions with high rates of ESBL-positive E. coli. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|