Antimicrobial susceptibility among organisms from the Asia/Pacific Rim, Europe and Latin and North America collected as part of TEST and the in vitro activity of tigecycline

Abstract

Objectives: To describe antimicrobial susceptibility among bacterial isolates associated with hospital infections collected from 266 centres in Asia/Pacific Rim (n 5 1947), North America (n 5 24 283), Latin America (n 5 1957) and Europe (n 5 8796).Methods: Isolates were collected from blood, respiratory tract, urine, skin, wound, body fluids and other defined sources between January 2004 and August 2006. Only one isolate per patient was accepted. In vitro MICs for the isolates were determined according to the CLSI (formerly NCCLS) guidelines.Results: Key organisms collected were Acinetobacter baumannii (n 5 2902), Enterobacter spp. (n 5 5731), Escherichia coli (n 5 6504), Klebsiella pneumoniae (n 5 4916), Pseudomonas aeruginosa (n 5 5128), Serratia marcescens (n 5 2313), Enterococcus faecalis (n 5 2701), Enterococcus faecium (n 5 1035) and Staphylococcus aureus (n 5 5753). Rates of methicillin resistance among S. aureus and of vancomycin resistance among enterococci were highest in North America (2016/3809, 52.9% and 571/2544, 22.4%, respectively) and lowest in Europe (337/1340, 25.1% and 36/916, 3.9%, respectively). Tigecycline was the only antimicrobial to maintain activity against all Gram-positive isolates (MIC 90 values of 0.25 mg/L). Overall, tigecycline and imipenem were the most active (>93% susceptibility in all regions) antimicrobials against the Gram-negative species, except for A. baumannii and P. aeruginosa. Piperacillin/tazobactam and amikacin were the most active against P. aeruginosa. Extended-spectrum b-lactamase producers among K. pneumoniae occurred most frequently in Latin America (124/282, 44.0%).Conclusions: Tigecycline is a novel broad-spectrum antimicrobial that is active against the common organisms associated with infections.

Characterization of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates from the community in Morocco

“…b-Lactams (mainly extended-spectrum cephalosporins and carbapenems) and fluoroquinolones constitute the main therapeutic choices to treat infections caused by these microorganisms. However, resistance to these compounds has been reported increasingly frequently from different parts of the world in recent years (Cantó n et al, 2008;Reinert et al, 2007). The last European Antibiotic Resistance Surveillance System (http://www.ecdc.europa.eu/en/ activities/surveillance/EARS-Net) report from 2006, covering over 800 laboratories from 31 countries, showed a continuous increase since 2000 in invasive E. coli and K. pneumoniae isolates resistant to third-generation cephalosporins, with a prevalence of .10% for half of the enrolled countries.…”

Increasing prevalence of extended-spectrum-betalactamase among Gram-negative bacilli in Latin America: 2008 update from the Study for Monitoring Antimicrobial Resistance Trends (SMART)

“…18 Imipenem was the most active agent against both ESBL-producing E. coli and K. pneumoniae in SENTRY and TEST. 13,18 Overall susceptibility of ESBLproducing Klebsiella species reported by SENTRY for 1997 to 2002 showed resistance rates from 35.8% to 46.9%, although rates of ESBL-producing Klebsiella were lower in 2001 to 2002 (35.8% to 39.5%) compared to 1997 to 2000 (43.5 to 46.9%), highlighting yearly variations. 19 While ampicillin-sulbactam is still commonly used in some Latin American countries, both ESBL-producing and non-ESBL-producing E. coli and K. pneumoniae were highly resistant.…”

“…14 While 18.1% of E. coli from South America were ESBL positive, only 7.5% of isolates from North America were ESBL positive; 51.9% of K. pneumoniae from South America were ESBL producers versus 12.3% of North American strains. 13 In Brazil, 24% of 498 Enterobacteriaceae analyzed from 2002 to 2003 were ESBL producers, including 57% of the K. pneumoniae. 15 A similar study in Colombia in 2002 examined 1,074 E. coli and 394 K. pneumoniae clinical isolates and found a high prevalence of ESBLs in most hospitals, among both E. coli (11.8%) and K. pneumoniae (32.6%).…”

Revisión sistemática de la resistencia antimicrobiana en enterobacterias en aislamientos intrahospitalarios en Colombia

“…Con base en los estudios identificados, en los últimos años (2009 a 2011) la frecuencia de BLEE podría situarse entre 10,1 y 11,8 % en E. coli y entre 14,6 y 32,6 % en K. pneumoniae. A nivel mundial, los datos del estudio TEST (Tigecycline Evaluation and Surveillance Trial) (56)(57)(58)(59), los del proyecto Sentry (60) y los del estudio SMART (Study for Monitoring Antimicrobial Resistance Trends) muestran cómo en la última década las tasas más altas se observan en Asia, seguidas por las de América Latina y, por último, las de los países desarrollados (61)(62)(63). Al comparar la situación de Colombia con los datos reportados, en el caso de K. pneumoniae productora de BLEE el país estaría al nivel de América Latina, con las tasas de resistencia más altas.…”