Pseudomonas aeruginosa Antimicrobial Susceptibility Results from Four Years (2012 to 2015) of the International Network for Optimal Resistance Monitoring Program in the United States

represents a major cause of health care-associated infections, and inappropriate initial antimicrobial therapy is associated with increased morbidity and mortality. The International Network for Optimal Resistance Monitoring (INFORM) program monitors the activity of ceftazidime-avibactam and many co...

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Bibliographic Details
Published in:Antimicrobial agents and chemotherapy 2017-03, Vol.61 (3)
Main Authors: Sader, Helio S, Huband, Michael D, Castanheira, Mariana, Flamm, Robert K
Format: Article
Language:English
Subjects:
Amikacin
Amikacin - pharmacology
Anti-Bacterial Agents
Anti-Bacterial Agents - pharmacology
Azabicyclo Compounds
Azabicyclo Compounds - pharmacology
Bacteremia - drug therapy
Bacteremia - epidemiology
Bacteremia - microbiology
Ceftazidime
Ceftazidime - pharmacology
Colistin
Colistin - pharmacology
Drug Resistance, Multiple, Bacterial
Epidemiology and Surveillance
Humans
International Cooperation
Microbial Sensitivity Tests
Pneumonia, Bacterial - drug therapy
Pneumonia, Bacterial - epidemiology
Pneumonia, Bacterial - microbiology
Pseudomonas aeruginosa
Pseudomonas aeruginosa - drug effects
Pseudomonas aeruginosa - growth & development
Pseudomonas aeruginosa - isolation & purification
Pseudomonas Infections - drug therapy
Pseudomonas Infections - epidemiology
Pseudomonas Infections - microbiology
Public Health Surveillance
Skin Diseases, Infectious - drug therapy
Skin Diseases, Infectious - epidemiology
Skin Diseases, Infectious - microbiology
Treatment Outcome
United States - epidemiology
Urinary Tract Infections - drug therapy
Urinary Tract Infections - epidemiology
Urinary Tract Infections - microbiology
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Summary:represents a major cause of health care-associated infections, and inappropriate initial antimicrobial therapy is associated with increased morbidity and mortality. The International Network for Optimal Resistance Monitoring (INFORM) program monitors the activity of ceftazidime-avibactam and many comparator agents. We evaluated the antimicrobial susceptibility of 7,452 isolates collected from 79 U.S. medical centers in 2012 to 2015. The isolates were collected and tested consecutively for susceptibility by broth microdilution method. Infection types included mainly pneumonia (50.5%), skin and skin structure (24.0%), urinary tract (7.8%), and bloodstream (7.7%) infections. The only compounds with >90% susceptibility rates were colistin (MIC , 1/2 mg/liter, respectively; 99.4% susceptible), ceftazidime-avibactam (MIC , 2/4 mg/liter, respectively; 97.0% susceptible), and amikacin (MIC , 2/8 mg/liter, respectively; 97.0/93.0% susceptible [CLSI/EUCAST, respectively]). The addition of avibactam to ceftazidime increased the percentage of susceptible isolates from 84.3% to 97.0%. Multidrug resistance (MDR) and extensive drug resistance (XDR) phenotypes were observed among 1,151 (15.4%) and 698 (9.4%) isolates, respectively, and ceftazidime-avibactam inhibited 82.1 and 75.8% of these isolates at ≤8 mg/liter, respectively. High rates of cross-resistance were observed with ceftazidime, meropenem, and piperacillin-tazobactam, whereas ceftazidime-avibactam retained activity against isolates nonsusceptible to ceftazidime (81.0% susceptible), meropenem (86.2% susceptible), and piperacillin-tazobactam (85.4% susceptible), as well as isolates nonsusceptible to these three β-lactams (71.2% susceptible). The only antimicrobial combinations that provided a better overall anti- coverage than ceftazidime-avibactam (97.0% susceptibility rate) were those including amikacin (97.0 to 98.4% coverage). Susceptibility rates remained stable during the study period. The results of this investigation highlight the challenge of optimizing empirical antimicrobial therapy for infections.
ISSN:0066-4804
1098-6596
DOI:10.1128/aac.02252-16