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Trending antibiotic resistance rates at a rural medical center 5 Yrs, 1 yr and 6 mos

Trending antibiotic resistance rates at a rural medical center 5 Yrs, 1 yr and 6 mos

Abstracts of the General Meeting of the American Society for Microbiology 103: C-446

Background: We have been a member of TSN since 1993 and have previously reported on its use in a variety of areas: oral infections and urinary tract infections. Here we wanted to trend emerging antibiotic resistance over 5 years and compare 1 year with 6 months to unmask potential bug/drug resistance. Methods: We analyzed the activity of nine antibiotics against 10 selected bacteria recovered from West Virginia University Hospital patients. We tracked antibiotic MICs for 5 years (1997-2001), one year (08/2001-07/2002), and six months (05/2002-10/2002). Comparisons were made based on changes of 4 resistant categories: 1) Stability <10%, 2) Minor gtoreq10-25%, Major gtoreq25-75%, and Very Major >75%. Differences in resistance were considered to be clinically significant if they were gtoreq20% higher/lower than the entire population and had gtoreq15% of the specific isolates for WVUH. We gathered data from The Surveillance Network (TSN) Database-USA (Herndon, VA) which is an electronic surveillance system. Results: Very Major increases in resistance were observed between vancomycin and Enterococcus faecalis, although resistant isolates detected remained low at 2.1%. Other Very Major or Major resistance increases were noted between ciprofloxacin and Escherichia coli, Klebsiella oxytoca, Enterobacter cloacae, and Pseudomonas aeruginosa, as well as between imipenem/cilastatin and P. aeruginosa. Several Major increases were also detected between ceftazidime and E. coli, K. oxytoca, E. cloacae, and P. aeruginosa, although the other third generation cephalosporins did not show a similar trend; in fact, stable or decreasing resistance patterns for ceftriaxone and cefotaxime against gram-negative bacteria were noted. Penicillin-resistant Streptococcus pneumoniae remained stable at 25-28%. Conclusions: Yearly antibiograms are the traditional means of establishing susceptibility profiles within an institution. We found trending selected bug/drug combinations best defined WVUH emerging resistance. Those bug/drug combinations highlighted by CDC were very evident.

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Accession: 035985089

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