Increasing prevalence of extended-spectrum-betalactamase among Gram-negative bacilli in Latin America: 2008 update from the Study for Monitoring Antimicrobial Resistance Trends (SMART)
OBJECTIVES: This analysis of the Study for Monitoring Antimicrobial Resistance Trends (SMART) evaluated the susceptibility patterns of Enterobacteriaceae in Latin America in 2008, with emphasis on susceptibility trends of E. coli and K. pneumoniae. METHODS: Clinical isolates were recovered from intr...
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| Format: | Article |
| Language: | English |
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Elsevier
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| Series: | Brazilian Journal of Infectious Diseases |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702011000100007&lng=en&tlng=en |
| _version_ | 1818134149697896448 |
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| author | Maria Virginia Villegas Manuel Guzmán Blanco Jose Sifuentes-Osornio Flávia Rossi |
| author_facet | Maria Virginia Villegas Manuel Guzmán Blanco Jose Sifuentes-Osornio Flávia Rossi |
| author_sort | Maria Virginia Villegas |
| collection | DOAJ |
| description | OBJECTIVES: This analysis of the Study for Monitoring Antimicrobial Resistance Trends (SMART) evaluated the susceptibility patterns of Enterobacteriaceae in Latin America in 2008, with emphasis on susceptibility trends of E. coli and K. pneumoniae. METHODS: Clinical isolates were recovered from intra-abdominal infections (IAI) from 23 centers in 10 Latin American countries. Isolates were sent to a central laboratory for confirmation of identification, antimicrobial susceptibility and ESBL testing, following the Clinical Laboratory Standards Institute (CLSI) guidelines. RESULTS: Of 1,003 Gram-negative bacilli collected from intra-abdominal infections, E. coli and K. pneumoniae were the most commonly isolated organisms, and 26.8% of E. coli and 37.7% of K. pneumoniae were ESBL positive. Ertapenem and imipenem were the most consistently active agents tested; 99% of ESBLpositive E. coli isolates were susceptible to ertapenem and 100% to imipenem as well, and 91% of ESBL-positive K. pneumoniae were susceptible to ertapenem and 98% to imipenem. Quinolones and cephalosporins were less active, achieving 1.5% to 76% inhibition against ESBL-producing E. coli and 3.5% to 61% inhibition against K. pneumoniae. CONCLUSIONS: Local and unit-specific surveillance data is particularly important for selection of empiric therapy and in community-acquired infections as they can help the clinician with antibiotic selection by providing guidance regarding the likely pathogens and their resistance profiles. Our data also confirm the increasing frequency with which ESBL-producing organisms are found in the community setting, with 31.4% of communityacquired and 24.9% of hospital-acquired infections found to produce ESBLs. Imipenem and ertapenem are the most active agents tested for ESBL-positive E. coli and K. pneumoniae. |
| first_indexed | 2024-12-11T09:04:02Z |
| format | Article |
| id | doaj.art-37dd054a21a944ddba64554228a98724 |
| institution | Directory Open Access Journal |
| issn | 1678-4391 |
| language | English |
| last_indexed | 2024-12-11T09:04:02Z |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-37dd054a21a944ddba64554228a987242022-12-22T01:13:40ZengElsevierBrazilian Journal of Infectious Diseases1678-4391151343910.1590/S1413-86702011000100007S1413-86702011000100007Increasing prevalence of extended-spectrum-betalactamase among Gram-negative bacilli in Latin America: 2008 update from the Study for Monitoring Antimicrobial Resistance Trends (SMART)Maria Virginia Villegas0Manuel Guzmán Blanco1Jose Sifuentes-Osornio2Flávia Rossi3International Center for Medical Research and TrainingCentro Médico de CaracasInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránUniversidade de São PauloOBJECTIVES: This analysis of the Study for Monitoring Antimicrobial Resistance Trends (SMART) evaluated the susceptibility patterns of Enterobacteriaceae in Latin America in 2008, with emphasis on susceptibility trends of E. coli and K. pneumoniae. METHODS: Clinical isolates were recovered from intra-abdominal infections (IAI) from 23 centers in 10 Latin American countries. Isolates were sent to a central laboratory for confirmation of identification, antimicrobial susceptibility and ESBL testing, following the Clinical Laboratory Standards Institute (CLSI) guidelines. RESULTS: Of 1,003 Gram-negative bacilli collected from intra-abdominal infections, E. coli and K. pneumoniae were the most commonly isolated organisms, and 26.8% of E. coli and 37.7% of K. pneumoniae were ESBL positive. Ertapenem and imipenem were the most consistently active agents tested; 99% of ESBLpositive E. coli isolates were susceptible to ertapenem and 100% to imipenem as well, and 91% of ESBL-positive K. pneumoniae were susceptible to ertapenem and 98% to imipenem. Quinolones and cephalosporins were less active, achieving 1.5% to 76% inhibition against ESBL-producing E. coli and 3.5% to 61% inhibition against K. pneumoniae. CONCLUSIONS: Local and unit-specific surveillance data is particularly important for selection of empiric therapy and in community-acquired infections as they can help the clinician with antibiotic selection by providing guidance regarding the likely pathogens and their resistance profiles. Our data also confirm the increasing frequency with which ESBL-producing organisms are found in the community setting, with 31.4% of communityacquired and 24.9% of hospital-acquired infections found to produce ESBLs. Imipenem and ertapenem are the most active agents tested for ESBL-positive E. coli and K. pneumoniae.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702011000100007&lng=en&tlng=encarbapenemsbeta-lactamasesGram-negative bacteriadrug resistanceESBL |
| spellingShingle | Maria Virginia Villegas Manuel Guzmán Blanco Jose Sifuentes-Osornio Flávia Rossi Increasing prevalence of extended-spectrum-betalactamase among Gram-negative bacilli in Latin America: 2008 update from the Study for Monitoring Antimicrobial Resistance Trends (SMART) Brazilian Journal of Infectious Diseases carbapenems beta-lactamases Gram-negative bacteria drug resistance ESBL |
| title | Increasing prevalence of extended-spectrum-betalactamase among Gram-negative bacilli in Latin America: 2008 update from the Study for Monitoring Antimicrobial Resistance Trends (SMART) |
| title_full | Increasing prevalence of extended-spectrum-betalactamase among Gram-negative bacilli in Latin America: 2008 update from the Study for Monitoring Antimicrobial Resistance Trends (SMART) |
| title_fullStr | Increasing prevalence of extended-spectrum-betalactamase among Gram-negative bacilli in Latin America: 2008 update from the Study for Monitoring Antimicrobial Resistance Trends (SMART) |
| title_full_unstemmed | Increasing prevalence of extended-spectrum-betalactamase among Gram-negative bacilli in Latin America: 2008 update from the Study for Monitoring Antimicrobial Resistance Trends (SMART) |
| title_short | Increasing prevalence of extended-spectrum-betalactamase among Gram-negative bacilli in Latin America: 2008 update from the Study for Monitoring Antimicrobial Resistance Trends (SMART) |
| title_sort | increasing prevalence of extended spectrum betalactamase among gram negative bacilli in latin america 2008 update from the study for monitoring antimicrobial resistance trends smart |
| topic | carbapenems beta-lactamases Gram-negative bacteria drug resistance ESBL |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702011000100007&lng=en&tlng=en |
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