Distribution and antimicrobial susceptibility of bacteria from adults with community-acquired pneumonia or complicated skin and soft tissue infections in France: the nationwide French PREMIUM study

Abstract

The empirical therapy of community-acquired pneumonia (CAP) and complicated skin and soft tissue infections (cSSTIs) must be based on updated bacterial distribution and susceptibility data. A nationwide study consecutively collected 1288 isolates from CAP (n=467) and cSSTIs (n=821) from 18 French hospitals between 2012 and 2013. The MIC values of commonly used antimicrobial agents, including ceftaroline, were determined. Bacterial distribution featured Pneumococcus, Haemophilus influenzae, and Staphylococcus aureus for CAPs and S. aureus, β-hemolytic streptococci and Enterobacteriaceae for cSSTIs. Antimicrobial susceptibility testing indicated i) the sustained third-generation cephalosporins and levofloxacin activity against pneumococci and H. influenzae, ii) no methicillin-resistant Staphylococcus aureus emergence among respiratory pathogens, iii) the high in vitro activity of ceftaroline against staphylococci from cSSTIs (98.7% susceptibility), and iv) the worrisome decreasing fluoroquinolone and third-generation cephalosporin susceptibilities among Enterobacteriaceae. This laboratory-based survey depicts a contrasting situation and supports the scoring of patients for the resistant pathogen risk before empirical therapy.

Microbial Distribution and Antibiotic Susceptibility in Patients with Complicated Skin and Soft Tissue Infections of the Extremities in North-Eastern China

“…Our retrospective study con rmed that the most common bacteria identi ed in cSSTIs of the extremities were GPB (including S.aureus (34%) and Streptococci spp. (16%)), similar with the previous European studies [9,10]. But another Chinese study [11] reported that Escherichia coli was the most commonly found bacterium in cSSTIs.…”

“…Somewhat surprisingly, in our 64 strains of S. aureus isolates, only 5 (7.8%) strains were MRSA. This result appeared low and was at odds with other published studies reporting ranges from 20.2% in Europe to 74.8% in the USA [6,9], which suggested that cSSTIs caused by MRSA in north-eastern Chinese hospitals was not as common as in European or USA hospitals. From our study, empirical antibiotic treatments for most patients with extremities' cSSTIs should cover MSSA rather than MRSA, and thus oxacillin, rst or second-generation cephalosporins, and levo oxacin should be options.…”

Economic analysis of ceftaroline fosamil for treating community-acquired pneumonia in Spain

“…changes in recommended dosages) will dictate modified cost-consequences results. Finally, susceptibility rates were not considered in the analysis, which might be a critical factor in countries with high levels of emerging antibiotic resistance 3,29 . Specifically, different types of causative organisms for CAP would have different susceptibility patterns with respect to each of the antimicrobial agents commonly used 29 , in turn affecting the clinical efficacy of each treatment.…”

“…Finally, susceptibility rates were not considered in the analysis, which might be a critical factor in countries with high levels of emerging antibiotic resistance 3,29 . Specifically, different types of causative organisms for CAP would have different susceptibility patterns with respect to each of the antimicrobial agents commonly used 29 , in turn affecting the clinical efficacy of each treatment. On one hand, this would require additional data regarding country-specific susceptibility patterns along with organism-specific clinical inputs for each comparator included in the analysis, thus significantly increasing the complexity of the analysis.…”