Antimicrobial resistance among gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004

Shawn R. Lockhart, Murray A. Abramson, Susan E. Beekmann, Gale Gallagher, Stefan Riedel, Daniel J. Diekema, John P. Quinn, Gary V. Doern

Research output: Contribution to journalArticle

Abstract

During the 12-year period from 1993 to 2004, antimicrobial susceptibility profiles of 74,394 gram-negative bacillus isolates recovered from intensive care unit (ICU) patients in United States hospitals were determined by participating hospitals and collected in a central location. MICs for 12 different agents were determined using a standardized broth microdilution method. The 11 organisms most frequently isolated were Pseudomonas aeruginosa (22.2%), Escherichia coli (18.8%), Klebsiella pneumoniae (14.2%), Enterobacter cloacae (9.1%), Acinetobacter spp. (6.2%), Serratia marcescens (5.5%), Enterobacter aerogenes (4.4%), Stenotrophomonas maltophilia (4.3%), Proteus mirabilis (4.0%), Klebsiella oxytoca (2.7%), and Citrobacter freundii (2.0%). Specimen sources included the lower respiratory tract (52.1%), urine (17.3%), and blood (14.2%). Rates of resistance to many of the antibiotics tested remained stable during the 12-year study period. Carbapenems were the most active drugs tested against most of the bacterial species. E. coli and P. mirabilis remained susceptible to most of the drugs tested. Mean rates of resistance to 9 of the 12 drugs tested increased with Acinetobacter spp. Rates of resistance to ciprofloxacin increased over the study period for most species. Ceftazidime was the only agent to which a number of species (Acinetobacter spp., C. freundii, E. aerogenes, K. pneumoniae, P. aeruginosa, and S. marcescens) became more susceptible. The prevalence of multidrug resistance, defined as resistance to at least one extended-spectrum cephalosporin, one aminoglycoside, and ciprofloxacin, increased substantially among ICU isolates of Acinetobacter spp., P. aeruginosa, K. pneumoniae, and E. cloacae.

Original languageEnglish (US)
Pages (from-to)3352-3359
Number of pages8
JournalJournal of Clinical Microbiology
Volume45
Issue number10
DOIs
StatePublished - Oct 2007
Externally publishedYes

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Acinetobacter
Bacillus
Intensive Care Units
Klebsiella pneumoniae
Citrobacter freundii
Pseudomonas aeruginosa
Enterobacter aerogenes
Enterobacter cloacae
Proteus mirabilis
Serratia marcescens
Ciprofloxacin
Infection
Klebsiella oxytoca
Pharmaceutical Preparations
Escherichia coli
Stenotrophomonas maltophilia
State Hospitals
Carbapenems
Ceftazidime
Multiple Drug Resistance

ASJC Scopus subject areas

  • Microbiology (medical)
  • Microbiology

Cite this

Antimicrobial resistance among gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004. / Lockhart, Shawn R.; Abramson, Murray A.; Beekmann, Susan E.; Gallagher, Gale; Riedel, Stefan; Diekema, Daniel J.; Quinn, John P.; Doern, Gary V.

In: Journal of Clinical Microbiology, Vol. 45, No. 10, 10.2007, p. 3352-3359.

Research output: Contribution to journalArticle

Lockhart, SR, Abramson, MA, Beekmann, SE, Gallagher, G, Riedel, S, Diekema, DJ, Quinn, JP & Doern, GV 2007, 'Antimicrobial resistance among gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004', Journal of Clinical Microbiology, vol. 45, no. 10, pp. 3352-3359. https://doi.org/10.1128/JCM.01284-07
Lockhart, Shawn R. ; Abramson, Murray A. ; Beekmann, Susan E. ; Gallagher, Gale ; Riedel, Stefan ; Diekema, Daniel J. ; Quinn, John P. ; Doern, Gary V. / Antimicrobial resistance among gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004. In: Journal of Clinical Microbiology. 2007 ; Vol. 45, No. 10. pp. 3352-3359.
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