Survey of Bloodstream Infections Due to Gram-Negative Bacilli: Frequency of Occurrence and Antimicrobial Susceptibility of Isolates Collected in the United States, Canada, and Latin America for the SENTRY Antimicrobial Surveillance Program, 1997

Abstract

During 1997, a total of 4,267 nosocomial and community-acquired bloodstream infections due to gram-negative organisms were reported from SENTRY hospitals in Canada (8 sites), the United States (30 sites), and Latin America (10 sites). Escherichia coli was the most common isolate (41% of all gram-negative isolates), followed by Klebsiella species (17.9%), Pseudomonas aeruginosa (10.6%), and Enterobacter species (9.4%). For all gram-negative isolates combined, the most active antimicrobials tested were meropenem, imipenem, and cefepime. The quinolones levofloxacin (MIC90, 2 microg/mL), ciprofloxacin (MIC90, 1 microg/mL), gatifloxacin (MIC90, 2 microg/mL), sparfloxacin (MIC90, 2 microg/mL), and trovafloxacin (MIC90, 2 microg/mL) were also active against most isolates. Bloodstream infection isolates from Latin America were uniformly more resistant to all classes of antimicrobial agents tested than were isolates from Canada or the United States. Resistance phenotypes consistent with extended-spectrum beta-lactamase production were also most common among E. coli and Klebsiella species from Latin America. Further investigation of the reasons for regional differences in resistance patterns is needed, as is ongoing surveillance to detect resistance trends and to guide antimicrobial use.

Prevalence of Candida species in umbilical catheters implanted in newborns in Natal, Brazil

“…These findings are compatible with those reported in the literature. Pfaller et al (9), in a study performed in the USA, Canada and South America, demonstrated 306 candidemia episodes in 34 medical centers. Of the cases reported, 50% occurred in patients hospitalized in NICUs, in which C. albicans was responsible for 53.3% of the blood infections, followed by C. parapsilosis (15.7%), C. glabrata (15%), C. tropicalis (7.8%), C. krusei (2%), C. guilliermondii (0.7%) and Candida spp.…”

The Ins and Outs of DNA Fingerprinting the Infectious Fungi

“…Particular groups of patients in intensive care units are at risk, especially bone marrow transplant recipients and other groups of immunosuppressed patients (24,47,154,165,302,402,414,421). Surveillance studies indicate that the frequency of BSI and other forms of invasive candidiasis acquired in hospital settings continues to increase (24,264). Therefore, DNA fingerprinting techniques have become critical tools in elucidating the sources of nosocomial infections, and although the large number of studies on nosocomial infections cannot be adequately reviewed here, the general application of DNA fingerprinting methods is considered.…”

Cyclic Di-GMP-Regulated Periplasmic Proteolysis of a Pseudomonas aeruginosa Type Vb Secretion System Substrate

“…However, a particular knowledge gap was evident in regard to Pseudomonas aeruginosa, where we detected genes encoding LapD-and LapGlike proteins but failed to identify a corresponding LapA-like target protein or associated transporters in its genome. As one of the most prevalent opportunistic pathogens, P. aeruginosa accounts for ϳ10% of hospital infections, notably in burn victims and sur-gical patients as well as those individuals with cystic fibrosis (8). These biofilm-based infections are notoriously difficult to treat, highlighting the importance of understanding the complex mechanisms controlling P. aeruginosa biofilm formation.…”