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Antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among Gram-negative organisms recovered during the SMART study in Spain (2011-2015)
INTRODUCTION: The SMART (Study for Monitoring Antimicrobial Resistance Trends) surveillance study monitors antimicrobial susceptibility and extended spectrum β-lactamases (ESBLs) in Gram-negative bacilli recovered from intra-abdominal infections (IAI). MATERIAL AND METHODS: Antimicrobial susceptibil...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedad Española de Quimioterapia
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159370/ https://www.ncbi.nlm.nih.gov/pubmed/29532655 |
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author | Cantón, Rafael Loza, Elena Aznar, Javier Barrón-Adúriz, Rubén Calvo, Jorge Castillo, F. Javier Cercenado, Emilia Cisterna, Ramón González-Romo, Fernando López-Hontangas, José Luis Suárez-Barrenechea, Ana Isabel Tubau, Fe Molloy, Brian López-Mendoza, Diego |
author_facet | Cantón, Rafael Loza, Elena Aznar, Javier Barrón-Adúriz, Rubén Calvo, Jorge Castillo, F. Javier Cercenado, Emilia Cisterna, Ramón González-Romo, Fernando López-Hontangas, José Luis Suárez-Barrenechea, Ana Isabel Tubau, Fe Molloy, Brian López-Mendoza, Diego |
author_sort | Cantón, Rafael |
collection | PubMed |
description | INTRODUCTION: The SMART (Study for Monitoring Antimicrobial Resistance Trends) surveillance study monitors antimicrobial susceptibility and extended spectrum β-lactamases (ESBLs) in Gram-negative bacilli recovered from intra-abdominal infections (IAI). MATERIAL AND METHODS: Antimicrobial susceptibility of 5,343 isolates from IAI recovered in 11 centres during the 2011-2015 SMART-Spain program was analysed by standard microdilution (EUCAST criteria) and compared with that from 2002-2010. ESBLs were phenotypically detected. RESULTS: Escherichia coli, the most common isolate, significantly decreased in community acquired IAI (60.9% 2002-2010 vs. 56.1% 2011-2015, P=0.0003). It was followed in prevalence by Klebsiella pneumoniae that increased both in the community (8.9% vs. 10.8%, P=0.016) and nosocomial (9.2% vs. 10.8%, P=0.029) IAI and P. aeruginosa, which significantly increased in community acquired IAI (5.6% vs. 8.0%, P=0.0003). ESBLs were more prevalent in K. pneumoniae (16.3%) than in E. coli (9.5%) of nosocomial origin and were more frequently isolated from elderly patients (>60 years). Considering all Enterobacteriaceae, ertapenem (92.3-100%) and amikacin (95.5%-100%) were the most active antimicrobials. Ertapenem activity, unlike amoxicillin-clavulanate or piperacillin-tazobactam, remained virtually unchanged in ESBL (100%) and non-ESBL (98.8%) E. coli producers. Its activity decreased in ESBL-K. pneumoniae (74.7%) but was higher than that of amoxicillin-clavulanate (14.0%) and piperacillin-tazobactam (24.0%). Interestingly, ertapenem susceptibility was maintained in >60% of ESBL isolates that were resistant to amoxicillin-clavulanate, piperacillin-tazobactam or fluoroquinolones. CONCLUSIONS: SMART-Spain results support current guidelines which include ertapenem as empiric treatment in mild-moderate community-acquired IAI, particularly with ESBL producers. These recommendations will need to be updated with the recently introduction of new antimicrobials. |
format | Online Article Text |
id | pubmed-6159370 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Sociedad Española de Quimioterapia |
record_format | MEDLINE/PubMed |
spelling | pubmed-61593702018-10-03 Antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among Gram-negative organisms recovered during the SMART study in Spain (2011-2015) Cantón, Rafael Loza, Elena Aznar, Javier Barrón-Adúriz, Rubén Calvo, Jorge Castillo, F. Javier Cercenado, Emilia Cisterna, Ramón González-Romo, Fernando López-Hontangas, José Luis Suárez-Barrenechea, Ana Isabel Tubau, Fe Molloy, Brian López-Mendoza, Diego Rev Esp Quimioter Original INTRODUCTION: The SMART (Study for Monitoring Antimicrobial Resistance Trends) surveillance study monitors antimicrobial susceptibility and extended spectrum β-lactamases (ESBLs) in Gram-negative bacilli recovered from intra-abdominal infections (IAI). MATERIAL AND METHODS: Antimicrobial susceptibility of 5,343 isolates from IAI recovered in 11 centres during the 2011-2015 SMART-Spain program was analysed by standard microdilution (EUCAST criteria) and compared with that from 2002-2010. ESBLs were phenotypically detected. RESULTS: Escherichia coli, the most common isolate, significantly decreased in community acquired IAI (60.9% 2002-2010 vs. 56.1% 2011-2015, P=0.0003). It was followed in prevalence by Klebsiella pneumoniae that increased both in the community (8.9% vs. 10.8%, P=0.016) and nosocomial (9.2% vs. 10.8%, P=0.029) IAI and P. aeruginosa, which significantly increased in community acquired IAI (5.6% vs. 8.0%, P=0.0003). ESBLs were more prevalent in K. pneumoniae (16.3%) than in E. coli (9.5%) of nosocomial origin and were more frequently isolated from elderly patients (>60 years). Considering all Enterobacteriaceae, ertapenem (92.3-100%) and amikacin (95.5%-100%) were the most active antimicrobials. Ertapenem activity, unlike amoxicillin-clavulanate or piperacillin-tazobactam, remained virtually unchanged in ESBL (100%) and non-ESBL (98.8%) E. coli producers. Its activity decreased in ESBL-K. pneumoniae (74.7%) but was higher than that of amoxicillin-clavulanate (14.0%) and piperacillin-tazobactam (24.0%). Interestingly, ertapenem susceptibility was maintained in >60% of ESBL isolates that were resistant to amoxicillin-clavulanate, piperacillin-tazobactam or fluoroquinolones. CONCLUSIONS: SMART-Spain results support current guidelines which include ertapenem as empiric treatment in mild-moderate community-acquired IAI, particularly with ESBL producers. These recommendations will need to be updated with the recently introduction of new antimicrobials. Sociedad Española de Quimioterapia 2018-07-12 2018-04 /pmc/articles/PMC6159370/ /pubmed/29532655 Text en © The Author 2018 https://creativecommons.org/licenses/by-nc/4.0/ The article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | Original Cantón, Rafael Loza, Elena Aznar, Javier Barrón-Adúriz, Rubén Calvo, Jorge Castillo, F. Javier Cercenado, Emilia Cisterna, Ramón González-Romo, Fernando López-Hontangas, José Luis Suárez-Barrenechea, Ana Isabel Tubau, Fe Molloy, Brian López-Mendoza, Diego Antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among Gram-negative organisms recovered during the SMART study in Spain (2011-2015) |
title | Antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among Gram-negative organisms recovered during the SMART study in Spain (2011-2015) |
title_full | Antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among Gram-negative organisms recovered during the SMART study in Spain (2011-2015) |
title_fullStr | Antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among Gram-negative organisms recovered during the SMART study in Spain (2011-2015) |
title_full_unstemmed | Antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among Gram-negative organisms recovered during the SMART study in Spain (2011-2015) |
title_short | Antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among Gram-negative organisms recovered during the SMART study in Spain (2011-2015) |
title_sort | antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among gram-negative organisms recovered during the smart study in spain (2011-2015) |
topic | Original |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159370/ https://www.ncbi.nlm.nih.gov/pubmed/29532655 |
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