Abstract:
:As part of the SENTRY Antimicrobial Surveillance Program, 1562 bacterial isolates were recovered from hospitalized patients with skin and soft tissue infections (SSTIs) in 30 United States (U.S.) and 8 Canadian medical centers between October and December, 1997. The overall rank order of recovery of the six most common pathogens was Staphylococcus aureus (42.6%) > Pseudomonas aeruginosa (11.3%) > Enterococcus spp. (8.1%) > Escherichia coli (7.2%) > Enterobacter spp. (5.2%) > beta-hemolytic streptocci (5.1%). With one exception, essentially the same order was observed in both the U.S. and Canada. The single exception was the Enterococcus group, which were the third most common isolate in the U.S. (9.6%), but the seventh most common isolate in Canada (3.7). Of note, 24.0% of S. aureus isolates were oxacillin resistant; vancomycin was uniformly active. Vancomycin resistance among Enterococcus spp. (16.5%) was observed only in the U.S. Several antimicrobial agents remained broadly active for SSTI isolates of P. aeruginosa, including meropenem, amikacin, tobramycin, and piperacillin with or without tazobactam. Imipenem resistance (MICs, > or = 8 micrograms/mL) was observed in 11.9% of isolates of P. aeruginosa and ceftazidime, and cefepime had equivalent activity (85.2% and 85.8% susceptible, respectively). Numerous beta-lactams, aminoglycosides and fluoroquinolones were broadly active against E. coli SSTI isolates (i.e. < 5% resistance). Extended-spectrum beta-lactamase production was uncommon both with E. coli and Klebsiella spp. in both nations. Cefepime, imipenem, and meropenem; the aminoglycosides; and fluoroquinolones were conspicuously more active against Enterobacter spp. than other agents tested. High-level, stably derepressed Amp C beta-lactamase production was commonly observed in this group (26.8%), but cefepime generally retained activity against these ceftazidime-resistant organisms. The results of this study serve to define the most common bacterial causes of SSTIs in North America, elucidate patterns of antimicrobial resistance and can be used as a basis for making initial empiric antimicrobial management decisions in hospitalized patients with such infections.
journal_name
Diagn Microbiol Infect Disjournal_title
Diagnostic microbiology and infectious diseaseauthors
Doern GV,Jones RN,Pfaller MA,Kugler KC,Beach MLdoi
10.1016/s0732-8893(98)00162-xsubject
Has Abstractpub_date
1999-05-01 00:00:00pages
65-72issue
1eissn
0732-8893issn
1879-0070pii
S073288939800162Xjournal_volume
34pub_type
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