Antimicrobial Susceptibility of Enterobacteriaceae and Pseudomonas aeruginosa Isolates from United States Medical Centers Stratified by Infection Type: Results from the International Network for Optimal Resistance Monitoring (INFORM) Surveillance Program, 2015-2016.

Abstract

A total of 18,656 Enterobacteriaceae and 4,175 Pseudomonas aeruginosa were consecutively collected from 85 US hospitals and tested for susceptibility by broth microdilution methods in a central monitoring laboratory (JMI Laboratories). The antimicrobial susceptibility and frequency of key resistance phenotypes were assessed and stratified by infection type as follows: bloodstream (BSI; 3,434 isolates; 15.0%), pneumonia (6,439; 28.2%), skin and skin structure (SSSI; 4,134; 18.1%), intra-abdominal (IAI; 951; 4.2%), and urinary tract (UTI; 7,873; 34.5%). Ceftazidime-avibactam was active against 99.9% to 100.0% of Enterobacteriaceae and 97.0% (pneumonia) to 99.4% (UTI) of P. aeruginosa isolates. Susceptibility rates were consistently lower for β-lactams, such as ceftazidime (82.3% vs. 87.1-90.8%), piperacillin-tazobactam (87.5% vs. 90.2-95.6%), and meropenem (96.8% vs. 98.4-99.4%) among Enterobacteriaceae from pneumonia compared to other infection types. Susceptibility to gentamicin was also generally lower among isolates from pneumonia, whereas susceptibility to levofloxacin and colistin were lowest among BSI and SSSI isolates, respectively. The occurrence of multidrug-resistance (MDR; 8.2% overall), extensively drug-resistance (XDR; 1.1% overall), and carbapenem-resistant Enterobacteriaceae (CRE; 1.3% overall) phenotypes were markedly higher among isolates from patients with pneumonia compared to other infection types. Among P. aeruginosa, susceptibility rates for ceftazidime, piperacillin-tazobactam, and gentamicin were lowest among isolates from pneumonia, whereas susceptibility to meropenem was similar among isolates from BSI, pneumonia, and IAI (77.3-77.9%), and susceptibility to levofloxacin was markedly lower among UTI isolates (67.1%). The frequencies of P. aeruginosa isolates with MDR and XDR phenotypes were highest among isolates from patients with pneumonia.

• Authors: Helio S Sader, Mariana Castanheira, Leonard R Duncan, Robert K Flamm
• Journal: Diagnostic microbiology and infectious disease (Diagn Microbiol Infect Dis) Vol. 92 Issue 1 Pg. 69-74 (Sep 2018) ISSN: 1879-0070 [Electronic] United States
• PMID: 29789189 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Azabicyclo Compounds
• Drug Combinations
• Thienamycins
• avibactam, ceftazidime drug combination
• Piperacillin, Tazobactam Drug Combination
• Penicillanic Acid
• Ceftazidime
• Meropenem
• Piperacillin
• Colistin

Topics

• Anti-Bacterial Agents (therapeutic use)
• Azabicyclo Compounds (therapeutic use)
• Ceftazidime (therapeutic use)
• Colistin (therapeutic use)
• Cross Infection (drug therapy)
• Drug Combinations
• Drug Resistance, Multiple, Bacterial (drug effects)
• Enterobacteriaceae (drug effects)
• Enterobacteriaceae Infections (drug therapy)
• Humans
• Meropenem
• Microbial Sensitivity Tests (methods)
• Penicillanic Acid (analogs & derivatives, therapeutic use)
• Piperacillin (therapeutic use)
• Piperacillin, Tazobactam Drug Combination
• Pseudomonas Infections (drug therapy)
• Pseudomonas aeruginosa (drug effects)
• Thienamycins (therapeutic use)
• United States