Antimicrobial susceptibility of gram-positive bacteria isolated in brazilian hospitals participating in the SENTRY Program (2005-2008)

We report the antimicrobial susceptibility patterns of the most frequently isolated Gram-positive bacteria in the Brazilian hospitals participating in the SENTRYAntimicrobial Surveillance Program. The strains were consecutively collected (one per patient) between January 2005 and September 2008 and...

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Main Authors: Ana C. Gales, Helio S. Sader, Julival Ribeiro, Cassia Zoccoli, Afonso Barth, Antonio C. Pignatari
Format: Article
Language:English
Published: Elsevier
Series:Brazilian Journal of Infectious Diseases
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702009000200004&lng=en&tlng=en
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author Ana C. Gales
Helio S. Sader
Julival Ribeiro
Cassia Zoccoli
Afonso Barth
Antonio C. Pignatari
author_facet Ana C. Gales
Helio S. Sader
Julival Ribeiro
Cassia Zoccoli
Afonso Barth
Antonio C. Pignatari
author_sort Ana C. Gales
collection DOAJ
description We report the antimicrobial susceptibility patterns of the most frequently isolated Gram-positive bacteria in the Brazilian hospitals participating in the SENTRYAntimicrobial Surveillance Program. The strains were consecutively collected (one per patient) between January 2005 and September 2008 and susceptibility tested by reference broth microdilution methods at the JMI Laboratories (North Liberty, Iowa, USA). A total of 3,907 Gram-positive cocci were analyzed. The Gram-positive organisms most frequently isolated from bloodstream infections were Staphylococcus aureus (2,218 strains; 20.2% of total), coagulase-negative staphylococci (CoNS; 812 strains [14.7%]), and Enterococcus spp. (754 strains; 5.0%). S. aureus ranked first (28.1%) and Enterococcus faecalis ranked 7th (4.5%) among cases of skin and soft tissue infections. S. aureus was also the second most frequently isolated pathogen from patients with lower respiratory tract infections (24.9% of cases) after Pseudomonas aeruginosa (30.5%). Resistance to oxacillin was observed in 31.0% of S. aureus and the vast majority of oxacillin-resistant (MRSA) strains were also resistant to clindamycin, ciprofloxacin and levofloxacin. Vancomycin, linezolid and daptomycin were all very active against S. aureus strains tested (>99.9-100.0% susceptible), but daptomycin (MIC50, 0.25 g/mL and MIC90, 0.5 g/mL) was four- to eight-fold more potent than vancomycin (MIC50 and MIC90 of 1 g/mL) and linezolid (MIC50, 1 g/mL and MIC90, 2 g/mL). Vancomycin resistance increased significantly among enterococci during the study period, but it was restrict to only one medical center until 2007 and emerged in a second medical center in 2008. Daptomycin was the most active antimicrobial tested against enterococci in general (100.0% susceptible), followed by linezolid (99.9% susceptible), ampicillin (87.4%) and vancomycin (84.6%). In conclusion, daptomycin and linezolid showed excellent in vitro activity against contemporary Gram-positive organisms (3,907) collected in Brazilian hospitals monitored by the SENTRY Program, including MRSA, vancomycin-resistant enterococci (VRE) and other multidrugresistant organisms. Although vancomycin resistance rates in Brazil appears to be relatively low compared to those reported in the USA, VRE has emerged and rapidly disseminated in some Brazilian medical centers.
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spelling doaj.art-bcda3976b0a440dfb5b5a32e0d18e4ea2022-12-22T01:31:18ZengElsevierBrazilian Journal of Infectious Diseases1678-4391132909810.1590/S1413-86702009000200004S1413-86702009000200004Antimicrobial susceptibility of gram-positive bacteria isolated in brazilian hospitals participating in the SENTRY Program (2005-2008)Ana C. Gales0Helio S. Sader1Julival Ribeiro2Cassia Zoccoli3Afonso Barth4Antonio C. Pignatari5Universidade Federal de São PauloUniversidade Federal de São PauloHospital de Base do Distrito FederalLaboratório Médico Santa LuziaUniversidade Federal do Rio Grande do SulUniversidade Federal de São PauloWe report the antimicrobial susceptibility patterns of the most frequently isolated Gram-positive bacteria in the Brazilian hospitals participating in the SENTRYAntimicrobial Surveillance Program. The strains were consecutively collected (one per patient) between January 2005 and September 2008 and susceptibility tested by reference broth microdilution methods at the JMI Laboratories (North Liberty, Iowa, USA). A total of 3,907 Gram-positive cocci were analyzed. The Gram-positive organisms most frequently isolated from bloodstream infections were Staphylococcus aureus (2,218 strains; 20.2% of total), coagulase-negative staphylococci (CoNS; 812 strains [14.7%]), and Enterococcus spp. (754 strains; 5.0%). S. aureus ranked first (28.1%) and Enterococcus faecalis ranked 7th (4.5%) among cases of skin and soft tissue infections. S. aureus was also the second most frequently isolated pathogen from patients with lower respiratory tract infections (24.9% of cases) after Pseudomonas aeruginosa (30.5%). Resistance to oxacillin was observed in 31.0% of S. aureus and the vast majority of oxacillin-resistant (MRSA) strains were also resistant to clindamycin, ciprofloxacin and levofloxacin. Vancomycin, linezolid and daptomycin were all very active against S. aureus strains tested (>99.9-100.0% susceptible), but daptomycin (MIC50, 0.25 g/mL and MIC90, 0.5 g/mL) was four- to eight-fold more potent than vancomycin (MIC50 and MIC90 of 1 g/mL) and linezolid (MIC50, 1 g/mL and MIC90, 2 g/mL). Vancomycin resistance increased significantly among enterococci during the study period, but it was restrict to only one medical center until 2007 and emerged in a second medical center in 2008. Daptomycin was the most active antimicrobial tested against enterococci in general (100.0% susceptible), followed by linezolid (99.9% susceptible), ampicillin (87.4%) and vancomycin (84.6%). In conclusion, daptomycin and linezolid showed excellent in vitro activity against contemporary Gram-positive organisms (3,907) collected in Brazilian hospitals monitored by the SENTRY Program, including MRSA, vancomycin-resistant enterococci (VRE) and other multidrugresistant organisms. Although vancomycin resistance rates in Brazil appears to be relatively low compared to those reported in the USA, VRE has emerged and rapidly disseminated in some Brazilian medical centers.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702009000200004&lng=en&tlng=enAntimicrobial resistanceSENTRYnosocomial infectionsBrazil
spellingShingle Ana C. Gales
Helio S. Sader
Julival Ribeiro
Cassia Zoccoli
Afonso Barth
Antonio C. Pignatari
Antimicrobial susceptibility of gram-positive bacteria isolated in brazilian hospitals participating in the SENTRY Program (2005-2008)
Brazilian Journal of Infectious Diseases
Antimicrobial resistance
SENTRY
nosocomial infections
Brazil
title Antimicrobial susceptibility of gram-positive bacteria isolated in brazilian hospitals participating in the SENTRY Program (2005-2008)
title_full Antimicrobial susceptibility of gram-positive bacteria isolated in brazilian hospitals participating in the SENTRY Program (2005-2008)
title_fullStr Antimicrobial susceptibility of gram-positive bacteria isolated in brazilian hospitals participating in the SENTRY Program (2005-2008)
title_full_unstemmed Antimicrobial susceptibility of gram-positive bacteria isolated in brazilian hospitals participating in the SENTRY Program (2005-2008)
title_short Antimicrobial susceptibility of gram-positive bacteria isolated in brazilian hospitals participating in the SENTRY Program (2005-2008)
title_sort antimicrobial susceptibility of gram positive bacteria isolated in brazilian hospitals participating in the sentry program 2005 2008
topic Antimicrobial resistance
SENTRY
nosocomial infections
Brazil
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702009000200004&lng=en&tlng=en
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