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Trends in antimicrobial susceptibility of bacterial pathogens isolated from patients with bloodstream infections in North America SENTRY Program, 1997-2000



Trends in antimicrobial susceptibility of bacterial pathogens isolated from patients with bloodstream infections in North America SENTRY Program, 1997-2000



Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 41: 116



Background: From January 1997 through December 2000, 28,468 BSI bacterial pathogens were reported from 38 SENTRY Program hospitals in NA. Methods: S. aureus (SA), E. coli (EC) and coagulase-negative staphylococci (CoNS) were the most common pathogens; 55% of all BSI during the 4-yr period. Among the top 10 pathogens, 63% were Gram-positive (G+) cocci. The rank order of the top 10 BSI pathogens was essentially unchanged; however, some important trends were noted. Between 1997 and 2000, an increase in the % of BSI due to SA (22.9-27.9%) and Enterococcus spp. (9.5-10.3%) was noted, whereas a decrease was observed for EC (18.6-17.6%), CoNS (12.8-10.8%) and S. pneumoniae (SPN; 5.6-3.4%). 16 key organism-antimicrobial combinations were evaluated (NCCLS MICs) for possible trends in resistance. Results: No significant differences were observed for SPN vs penicillin (81.6-84.1% susceptible (S)); EC vs ceftazidime (CAZ; 98.6-99.4%) or cefepime (CPM; 99.7-100%); Klebsiella spp. vs CAZ (95.4-96.3%), CPM (98.8-99.6%), and imipenem (IMP; 100%); Enterobacter spp. vs CPM (99.0-100%). Decreased S was noted for SA vs oxacillin (78.2-66.8%); CoNS vs oxacillin (29.9-22.6%); Enterococcus spp. vs vancomycin (87.0-84.7%); and EC vs ciprofloxacin (97.5-95.1%). In contrast, increased S was noted for P. aeruginosa vs CPM, CAZ and IMP and Enterobacter spp. vs CAZ. Conclusions: Important changes over time in the spectrum of BSI pathogens in NA were noted and highlight the G+ cocci as increasingly significant causes. Likewise, increasing resistance was observed among staphylococci and enterococci. Ongoing surveillance (SENTRY) remains essential and should be used to enhance efforts to limit the extent of resistance worldwide.

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