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JAC Advance Access published online on May 22, 2006
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl199
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Received January 13, 2006
Revised April 24, 2006
Accepted April 25, 2006

Brief report

In vitro susceptibilities of aerobic and facultatively anaerobic Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends)

Flávia Rossi 1, Fernando Baquero 2, Po-Ren Hsueh 3, David L. Paterson 4, Grant V. Bochicchio 5, Theresa A. Snyder 6, Vilas Satishchandran 6, Kathleen McCarroll 6, Mark J. DiNubile 6, and Joseph W. Chow 6 *

1 Hospital das Clinicas da Faculdade de Medicina, São Paulo, LIM 03, Brazil
2 Hospital Ramon y Cajal, Madrid, Spain
3 National Taiwan University Hospital, Taipei, Taiwan
4 University of Pittsburgh Medical Center, Pittsburgh, PA, USA
5 University of Maryland Medical System, Baltimore, MD, USA
6 Merck Research Laboratories, North Wales, PA, USA

* To whom correspondence should be addressed.
Joseph W. Chow, E-mail: joseph_chow{at}merck.com


  Abstract

Objectives: SMART (Study for Monitoring Antimicrobial Resistance Trends) is an ongoing study to monitor worldwide antimicrobial resistance trends among aerobic and facultatively anaerobic Gram-negative bacilli (GNB) isolated from intra-abdominal infections. This 2004 report summarizes the most recently completed annual data from SMART.

Methods: During 2004, 81 medical centres from 28 countries in five global regions collected intra-abdominal GNB for antimicrobial susceptibility testing using broth microdilution according to the Clinical and Laboratory Standards Institute guidelines.

Results: A total of 6156 unique aerobic and facultatively anaerobic GNB were isolated from intra-abdominal infections. Enterobacteriaceae composed 86% of the total isolates. Among the 12 antimicrobial agents tested, the carbapenems and amikacin were the most consistently active against the Enterobacteriaceae. Escherichia coli was the most commonly isolated species (48%), and the susceptibility rate to the quinolones was lowest in Asia/Pacific and Latin America. Extended-spectrum {beta}-lactamases (ESBLs) were detected phenotypically in 10% of E. coli, 17% of Klebsiella spp. and 22% of Enterobacter spp. worldwide, representing a slight increase over the two previous years. ESBL producers typically had a more antibiotic-resistant profile than non-ESBL producers but were usually susceptible to the carbapenems.

Conclusions: Antimicrobial resistance among GNB isolated from intra-abdominal infections continued to be a problem worldwide in 2004, with the highest rates of resistance overall in the Asia/Pacific region. The carbapenems and amikacin were the most consistently active agents in vitro against Enterobacteriaceae isolated from intra-abdominal infections worldwide.

Keywords: Enterobacteriaceae; in vitro susceptibility; antimicrobial susceptibility; extended-spectrum {beta}-lactamases; ESBLs.
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