Epidemiologic Trends, Occurrence of Extended-Spectrum β-Lactamase Production, and Performance of Ertapenem and Comparators in Patients with Intra-Abdominal Infections: Analysis of Global Trend Data from 2002–2007 from the SMART Study
Abstract
Background: The Study for Monitoring Antimicrobial Resistance Trends (SMART) is an ongoing surveillance study to monitor worldwide resistance trends among aerobic and facultative anaerobic gram-negative bacilli isolated from intra-abdominal infections (IAIs). Results from SMART in 2002 through 2005 have been reported; this report summarizes aggregated data from SMART 2002–2007 to identify epidemiologic trends over time.
Methods: A cumulative total of 446 sites were involved, of which 119, 166, 66, 28, and 67 were in Asia/Pacific, Europe, Latin America, Middle East/Africa, and North America, respectively.
Results: A total of 34,635 isolates were collected from IAIs during 2002–2007, of which 32,113 (92.7%) were from 12 species. The organisms isolated most commonly were Escherichia coli (47.6%), Klebsiella pneumoniae (12.9%), and Pseudomonas aeruginosa (9.5%). The most frequent infection source associated with the 12 most common organisms consistently was peritoneal (46%), followed by intestine (15.8%) and liver (3.2%), with the majority of the organisms originating from inpatients (90.7%), followed by outpatients (4.3%) and undetermined sources (5.0%). Approximately 52% of these isolates were from patients with a hospital stay of ≥48 h, with 45.5% from patients with a hospital stay of <48 h. Overall, ertapenem and imipenem consistently were the most effective antibiotics, whereas resistance to other agents was more common.
Conclusions: Escherichia coli was the organism isolated most frequently from IAIs, of which the majority were from peritoneal and intestinal sources. Only the carbapenems maintained good activity against the majority of clinical isolates.
Get full access to this article
View all available purchase options and get full access to this article.
References
1.
Bochicchio GVBaquero FHsueh PR et al. In vitro susceptibilities of Escherichia coli isolated from patients with intra-abdominal infections worldwide in 2002–2004: Results from SMART (Study for Monitoring Antimicrobial Resistance Trends)Surg Infect20067537-545. 1. Bochicchio GV, Baquero F, Hsueh PR, et al. In vitro susceptibilities of Escherichia coli isolated from patients with intra-abdominal infections worldwide in 2002–2004: Results from SMART (Study for Monitoring Antimicrobial Resistance Trends). Surg Infect 2006;7:537–545.
2.
Rossi FBaquero FHsueh P-R et al. In vitro susceptibilities of aerobic and facultatively anaerobic gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends)J Antimicrob Chemother200658205-210. 2. Rossi F, Baquero F, Hsueh P-R, et al. In vitro susceptibilities of aerobic and facultatively anaerobic gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends). J Antimicrob Chemother 2006;58:205–210.
3.
Diekema DJPfaller MATurnidge J et al. Genetic relatedness of multidrug-resistant, methicillin (oxacillin)-resistant Staphylococcus aureus bloodstream isolates from SENTRY antimicrobial resistance surveillance centers worldwide, 1998Microb Drug Resist20006213-221. 3. Diekema DJ, Pfaller MA, Turnidge J, et al. Genetic relatedness of multidrug-resistant, methicillin (oxacillin)-resistant Staphylococcus aureus bloodstream isolates from SENTRY antimicrobial resistance surveillance centers worldwide, 1998. Microb Drug Resist 2000;6:213–221.
4.
Paterson DLRossi FBaquero F et al. 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)J Antimicrob Chemother200555965-973. 4. Paterson DL, Rossi F, Baquero F, et al. 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). J Antimicrob Chemother 2005;55:965–973.
5.
Clinical Laboratory Standards InstitutePerformance Standards for Antimicrobial Susceptibility Testing: Thirteenth Information Supplement M100-S18Clinical Laboratory Standards InstituteVillanova, PA2008. 5. Clinical Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Thirteenth Information Supplement M100-S18. Clinical Laboratory Standards Institute. Villanova, PA. 2008.
6.
Stone NDO'Hara CMWilliams PP et al. Comparison of disk diffusion, VITEK 2, and broth microdilution antimicrobial susceptibility test results for unusual species of EnterobacteriaceaeJ Clin Microbiol200745340-346. 6. Stone ND, O'Hara CM, Williams PP, et al. Comparison of disk diffusion, VITEK 2, and broth microdilution antimicrobial susceptibility test results for unusual species of Enterobacteriaceae. J Clin Microbiol 2007;45:340–346.
7.
Lockhart SRAbramson MABeekmann SE et al. Antimicrobial resistance among gram-negative bacilli causing infections in intensive care units in the United States between 1993 and 2004J Clin Microbiol2007453352-3359. 7. Lockhart SR, Abramson MA, Beekmann SE, et al. Antimicrobial resistance among gram-negative bacilli causing infections in intensive care units in the United States between 1993 and 2004. J Clin Microbiol 2007; 45:3352–3359.
8.
Baquero FHsueh P-RPaterson DL et al. In vitro susceptibilities of aerobic and facultatively anaerobic gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2005 results from SMART (Study for Monitoring Antimicrobial Resistance Trends)Surg Infect20091099-104. 8. Baquero F, Hsueh P-R, Paterson DL, et al. In vitro susceptibilities of aerobic and facultatively anaerobic gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2005 results from SMART (Study for Monitoring Antimicrobial Resistance Trends). Surg Infect 2009;10:99–104.
9.
Goossens HGrabein B. Prevalence and antimicrobial susceptibility data for extended-spectrum beta-lactamase and AmpC-producing Enterobacteriaceae from the MYSTIC program in Europe and the United States (1997–2004)Diagn Microbiol Infect Dis200553257-264. 9. Goossens H, Grabein B. Prevalence and antimicrobial susceptibility data for extended-spectrum beta-lactamase and AmpC-producing Enterobacteriaceae from the MYSTIC program in Europe and the United States (1997–2004). Diagn Microbiol Infect Dis 2005;53:257–264.
10.
Hirakata YMatsuda JMiyazaki Y et al. Regional variation in the prevalence of extended-spectrum beta-lactamase-producing clinical isolates in the Asia-Pacific region (SENTRY 1998–2002)Diagn Microbiol Infect Dis200552323-329. 10. Hirakata Y, Matsuda J, Miyazaki Y, et al. Regional variation in the prevalence of extended-spectrum beta-lactamase-producing clinical isolates in the Asia-Pacific region (SENTRY 1998–2002). Diagn Microbiol Infect Dis 2005;52:323–329.
11.
Sader HSHsiung AFritsche TR et al. Comparative activities of cefepime and piperacillin/tazobactam tested against a global collection of Escherichia coli and Klebsiella spp. with an ESBL phenotypeDiagn Microbiol Infect Dis200757341-344. 11. Sader HS, Hsiung A, Fritsche TR, et al. Comparative activities of cefepime and piperacillin/tazobactam tested against a global collection of Escherichia coli and Klebsiella spp. with an ESBL phenotype. Diagn Microbiol Infect Dis 2007;57:341–344.
12.
Chow JWSatishchandran VSnyder TA et al. In vitro susceptibilities of aerobic and facultative gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: The 2002 Study for Monitoring Antimicrobial Resistance Trends (SMART)Surg Infect20066439-447. 12. Chow JW, Satishchandran V, Snyder TA, et al. In vitro susceptibilities of aerobic and facultative gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: The 2002 Study for Monitoring Antimicrobial Resistance Trends (SMART). Surg Infect 2006;6:439–447.
13.
Bissett L. ESBL-producing Enterobacteriaceae: Controlling the spread of infectionBr J Nursing200716644-647. 13. Bissett L. ESBL-producing Enterobacteriaceae: Controlling the spread of infection. Br J Nursing 2007;16:644–647.
14.
Bush K. Extended-spectrum beta-lactamases in North America, 1987–2006Clin Microbiol Infection200814134-143. 14. Bush K. Extended-spectrum beta-lactamases in North America, 1987–2006. Clin Microbiol Infection 2008;14:134–143.
15.
Canton RNovais AValverde A et al. Prevalence and spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae in EuropeClin Microbiol Infect20081421-24. 15. Canton R, Novais A, Valverde A, et al. Prevalence and spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae in Europe. Clin Microbiol Infect 2008;14:21–24.
16.
Nicolas-Chanoine MHJarlier V. Extended-spectrum beta-lactamases in long-term-care facilitiesClin Microbiol Infection200714111-116. 16. Nicolas-Chanoine MH, Jarlier V. Extended-spectrum beta-lactamases in long-term-care facilities. Clin Microbiol Infection 2007;14:111–116.
17.
Pitout JDLaupland KB. Extended-spectrum beta-lactamase-producing Enterobacteriaceae: An emerging public-health concernLancet Infect Dis20088159-166. 17. Pitout JD, Laupland KB. Extended-spectrum beta-lactamase-producing Enterobacteriaceae: An emerging public-health concern. Lancet Infect Dis 2008;8:159–166.
18.
Bukholm GTannaes TKjelsberg ABSmith-Erichsen N. An outbreak of multidrug-resistant Pseudomonas aeruginosa associated with increased risk of patient death in an intensive care unitInfect Control Hosp Epidemiol200223441-446. 18. Bukholm G, Tannaes T, Kjelsberg AB, Smith-Erichsen N. An outbreak of multidrug-resistant Pseudomonas aeruginosa associated with increased risk of patient death in an intensive care unit. Infect Control Hosp Epidemiol 2002;23:441–446.
19.
Dorsey GBorneo HTSun SJ et al. A heterogeneous outbreak of Enterobacter cloacae and Serratia marcescens infections in a surgical intensive care unitInfect Control Hosp Epidemiol200221465-469. 19. Dorsey G, Borneo HT, Sun SJ, et al. A heterogeneous outbreak of Enterobacter cloacae and Serratia marcescens infections in a surgical intensive care unit. Infect Control Hosp Epidemiol 2002;21:465–469.
20.
Gastmeier PGroneberg KWeist KRuden H. A cluster of nosocomial Klebsiella pneumoniae bloodstream infections in a neonatal intensive care department: Identification of transmission and interventionAm J Infect Control200331424-430. 20. Gastmeier P, Groneberg K, Weist K, Ruden H. A cluster of nosocomial Klebsiella pneumoniae bloodstream infections in a neonatal intensive care department: Identification of transmission and intervention. Am J Infect Control 2003;31:424–430.
21.
Archibald LPhillips LMonnet D et al. Antimicrobial resistance in isolates from inpatients and outpatients in the United States: Increasing importance of the intensive care unitClin Infect Dis199724211-215. 21. Archibald L, Phillips L, Monnet D, et al. Antimicrobial resistance in isolates from inpatients and outpatients in the United States: Increasing importance of the intensive care unit. Clin Infect Dis 1997;24:211–215.
22.
Monnet DLArchibald LKPhillips L et al. Antimicrobial use and resistance in eight U.S. hospitals: Complexities of analysis and modeling. Intensive Care Antimicrobial Resistance Epidemiology Project and National Nosocomial Infections Surveillance System HospitalsInfect Control Hosp Epidemiol199819388-394. 22. Monnet DL, Archibald LK, Phillips L, et al. Antimicrobial use and resistance in eight U.S. hospitals: Complexities of analysis and modeling. Intensive Care Antimicrobial Resistance Epidemiology Project and National Nosocomial Infections Surveillance System Hospitals. Infect Control Hosp Epidemiol 1998;19:388–394.
23.
National Nosocomial Infections Surveillance System. NNIS Report: Data summary from January 1992 through June 2003, issued August 2003Am J Infect Control200331481-498. 23. National Nosocomial Infections Surveillance System. NNIS Report: Data summary from January 1992 through June 2003, issued August 2003. Am J Infect Control 2003;31:481–498.
24.
Lipsitch MLevin BR. The population dynamics of antimicrobial chemotherapyAntimicrob Agents Chemother199741363-373. 24. Lipsitch M, Levin BR. The population dynamics of antimicrobial chemotherapy. Antimicrob Agents Chemother 1997;41:363–373.
25.
Bonten MJWeinstein RA. The role of colonization in the pathogenesis of nosocomial infectionsInfect Control Hosp Epidemiol199617193-200. 25. Bonten MJ, Weinstein RA. The role of colonization in the pathogenesis of nosocomial infections. Infect Control Hosp Epidemiol 1996;17:193–200.
26.
Margreet PFilius GGyssens IC et al. Colonization and resistance dynamics of gram-negative bacteria in patients during and after hospitalizationAntimicrob Agents Chemother2005492879-2886. 26. Margreet P, Filius G, Gyssens IC, et al. Colonization and resistance dynamics of gram-negative bacteria in patients during and after hospitalization. Antimicrob Agents Chemother 2005;49:2879–2886.
Information & Authors
Information
Published In
Copyright
Copyright 2010, Mary Ann Liebert, Inc.
History
Published online: 9 August 2010
Published in print: August 2010
Topics
Authors
Metrics & Citations
Metrics
Citations
Export Citation
Export citation
Select the format you want to export the citations of this publication.
View Options
Get Access
Access content
To read the fulltext, please use one of the options below to sign in or purchase access.⚠ Society Access
If you are a member of a society that has access to this content please log in via your society website and then return to this publication.