Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2004 Jul 29:3:14.
doi: 10.1186/1476-0711-3-14.

Emerging resistance among bacterial pathogens in the intensive care unit--a European and North American Surveillance study (2000-2002)

Mark E Jones  1 , Deborah C Draghi, Clyde Thornsberry, James A Karlowsky, Daniel F Sahm, Richard P Wenzel
Affiliations

Emerging resistance among bacterial pathogens in the intensive care unit--a European and North American Surveillance study (2000-2002)

Mark E Jones et al. Ann Clin Microbiol Antimicrob. .

Abstract

Background: Globally ICUs are encountering emergence and spread of antibiotic-resistant pathogens and for some pathogens there are few therapeutic options available.

Methods: Antibiotic in vitro susceptibility data of predominant ICU pathogens during 2000-2 were analyzed using data from The Surveillance Network (TSN) Databases in Europe (France, Germany and Italy), Canada, and the United States (US).

Results: Oxacillin resistance rates among Staphylococcus aureus isolates ranged from 19.7% to 59.4%. Penicillin resistance rates among Streptococcus pneumoniae varied from 2.0% in Germany to as high as 20.2% in the US; however, ceftriaxone resistance rates were comparably lower, ranging from 0% in Germany to 3.4% in Italy. Vancomycin resistance rates among Enterococcus faecalis were < or = 4.5%; however, among Enterococcus faecium vancomycin resistance rates were more frequent ranging from 0.8% in France to 76.3% in the United States. Putative rates of extended-spectrum beta-lactamase (ESBL) production among Enterobacteriaceae were low, <6% among Escherichia coli in the five countries studied. Ceftriaxone resistance rates were generally lower than or similar to piperacillin-tazobactam for most of the Enterobacteriaceae species examined. Fluoroquinolone resistance rates were generally higher for E. coli (6.5% - 13.9%), Proteus mirabilis (0-34.7%), and Morganella morganii (1.6-20.7%) than other Enterobacteriaceae spp (1.5-21.3%). P. aeruginosa demonstrated marked variation in beta-lactam resistance rates among countries. Imipenem was the most active compound tested against Acinetobacter spp., based on resistance rates.

Conclusion: There was a wide distribution in resistance patterns among the five countries. Compared with other countries, Italy showed the highest resistance rates to all the organisms with the exception of Enterococcus spp., which were highest in the US. This data highlights the differences in resistance encountered in intensive care units in Europe and North America and the need to determine current local resistance patterns by which to guide empiric antimicrobial therapy for intensive care infections.

PubMed Disclaimer

References

    1. Kollef MH, Fraser VJ. Antibiotic resistance in the Intensive Care Unit. Ann Intern Med. 2001;134:298–314. - PubMed
    1. CDC NNIS system National nosocomial infections surveillance (NNIS) system report, data summary from January 1992-April issued August 2001. Amer J Infect Contr. 2001;29:400–421. doi: 10.1067/mic.2001.118408. Correction 2002, 30:74. - DOI - PubMed
    1. NNIS system report Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Surveillance report, data summary from January 1996 through December 1997. Amer J Infect Contr. 1999;27:279–284. doi: 10.1053/ic.1999.v27.a98878. - DOI - PubMed
    1. Fridkin SK, Steward CD, Edwards JR, Pryor ER, McGowan JE, Archibald LK, Gaynes RP, Tenover FC. Surveillance of antimicrobial use and antimicrobial resistance in United States hospitals: Project ICARE Phase 2. Project Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Hospitals. Clin Infec Dis. 1999;29:245–252. - PubMed
    1. Stephen J, Mutnick A, Jones RN. Assessment of pathogens and resistance (R) patterns among intensive care unit (ICU) in North America (NA): initial report from the SENTRY antimicrobial surveillance program (2001) Presented at the 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy, San Diego, CA. 2002. Abstract C2-297.