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Title: Antimicrobial Susceptibility of Gram-Negative Bacilli Isolated in Brazilian Hospitals Participating in the SENTRY Program (2003-2008)
Authors: Andrade, Soraya Sgambatti [UNIFESP]
Sader, Helio Silva [UNIFESP]
Barth, Afonso Luis
Ribeiro, Julival
Zoccoli, Cassia
Pignatari, Antonio Carlos Campos [UNIFESP]
Gales, Ana Cristina [UNIFESP]
JMI Labs
Universidade Federal de São Paulo (UNIFESP)
Hosp Clin Porto Alegre
Hosp Base Dist Fed
Lab Med Santa Luzia
Keywords: Hospital-acquired infections
Sentry Program
antimicrobial resistance
Gram-negative bacilli
Issue Date: 1-Oct-2008
Publisher: Contexto
Citation: Brazilian Journal Of Infectious Diseases. Salvador: Contexto, v. 12, p. 3-9, 2008.
Abstract: We report the antimicrobial susceptibility patterns of the five most frequently isolated Gram-negative bacilli in the Brazilian hospitals participating in the SENTRY Program. A total of 3,220 Gram-negative bacilli were analyzed. The strains were consecutively collected (one per patient) between January 2003 and May 2008 and susceptibility tested by reference broth microdilution methods at the JMI Laboratories (North Liberty, Iowa, USA). The Gram-negative organisms most frequently isolated from bloodstream infections were Escherichia coli (12.8% of total), Klebsiella spp.(12.5%), Pseudomonas aeruginosa (9.6%), Acinetobacter spp. (8.0%) and Enterobacter spp. (6.4%). P aeruginosa ranked first (36.3% of cases) among organisms isolated from patients with pneumonia and second (15.1%) among organisms isolated from skin and soft tissue infections. Approximately 10% of E. coli and 50% of K. pneumoniae exhibited an ESBL phenotype. The carbapenems imipenem and meropenem were very active against Enterobacteriaceae strains, including E. coli and K. pneumoniae with ESBL phenotype and cefepime-non-susceptible Enterobacter spp., while ertapenem and polymyxin B showed more limited activity against Enterobacter spp. P. aeruginosa and Acinetobacter spp. showed high rates of resistance to all compounds tested except polymyxin B (99.4-99.9% susceptible). No antimicrobial agent alone provided appropriate coverage for the Gram-negative bacilli most frequently isolated in the hospitals participating in the SENTRY Program; thus, empiric therapy for serious infections may require a carbapenem (imipenem or meropenem) plus a polymyxin (polymyxin B or colistin).
ISSN: 1413-8670
Appears in Collections:Artigo

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