In vitro susceptibilities of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: The 2003 Study for Monitoring Antimicrobial Resistance Trends (SMART)
Journal
Journal of Antimicrobial Chemotherapy
Journal Volume
55
Journal Issue
6
Pages
965-973
Date Issued
2005
Author(s)
Paterson D.L.
Rossi F.
Baquero F.
Woods G.L.
Satishchandran V.
Snyder T.A.
Harvey C.M.
Teppler H.
DiNubile M.J.
Chow J.W.
Abstract
OBJECTIVES: The SMART (Study for Monitoring Antimicrobial Resistance Trends) surveillance programme was begun in 2002 to monitor antimicrobial resistance trends among aerobic and facultative Gram-negative bacilli (GNB) isolated from intra-abdominal infections worldwide. METHODS: In 2003, 74 medical centres from 23 countries collected isolates for testing. Antimicrobial susceptibility testing was performed using broth microdilution according to the NCCLS guidelines for MIC testing. RESULTS: A total of 5658 aerobic and facultative GNB were isolated from intra-abdominal infections. Enterobacteriaceae composed 84% of the total isolates. Among the agents tested, the carbapenems were the most consistently active against the Enterobacteriaceae. E. coli was the most common isolate (46%), and the susceptibility rate to the quinolone (70-90% susceptible), cephalosporin (80-97% susceptible), aminoglycoside (77-100% susceptible) and carbapenem (99-100% susceptible) agents tested varied among geographic regions, with isolates from the Asia/Pacific region generally being the most resistant. Extended-spectrum beta-lactamases (ESBLs) were detected phenotypically in 9% of E. coli, 14% of Klebsiella spp., and 14% of Enterobacter spp. worldwide. ESBL producers generally had a more antibiotic-resistant profile than non-ESBL producers. CONCLUSIONS: Antimicrobial resistance among GNB isolated from intra-abdominal infections is a problem worldwide, especially in the Asia/Pacific region. The carbapenems ertapenem, meropenem and imipenem are highly active in vitro against Enterobacteriaceae isolated from intra-abdominal sites, including organisms that produce ESBLs.
Type
journal article