Inducible Amp C bêta-lactamase producing gram-negative bacilli from blood stream infections : Frequency, antimicrobial susceptibility, and molecular epidemiology in a national surveillance program (SCOPE).
A surveillance study of nosocomial blood stream infections [Surveillance and Control of Pathogens of Epidemiologic Importance (SCOPE) ] was conducted during a 14-month period in 1995 to 1996 in approximately 50 American medical centers.
Among the 4725 blood stream infections, the etiologic agent was Enterobacter spp. in 230, Citrobacter freundii in 24, and Serratia marcescens in 65.
The vast majority of these isolates (89%) had been sent to the University of Iowa including 198 Enterobacter spp. (46 Enterobacter aerogenes, 141 Enterobacter cloacae, 11 other Enterobacter spp.), 23 C. freundii, and 62 S. marcescens.
Because these species are capable of producing Amp C bêta-lactamase, we examined their susceptibility to 12 broad-spectrum antimicrobial agents.
The frequency of resistance to ceftazidime and the molecular epidemiology of ceftazidime-resistant strains was also examined.
Among the Enterobacter spp. and C. freundii isolates, resistance to third generation cephalosporins (ceftazidime, ceftriaxone) and broad-spectrum semisynthetic penicillins (piperacillin), with or without an enzyme inhibitor (piperacillin/tazobactam), was high, e.g., 35 to 50%. The S. marcescens isolates were quite susceptible to all agents tested.
Both imipenem and cefepime were active against virtually all isolates tested including 84 stably derepressed Amp C-producing ceftazidime-resistant strains of Enterobacter spp. and C. freundii. (...)
Mots-clés Pascal : Epidémiologie moléculaire, Surveillance population, Sensibilité résistance, Antibactérien, bêta-Lactamase, Hydrolases, Enzyme, Bactérie, Etats Unis, Amérique du Nord, Amérique, Septicémie, Infection nosocomiale, Homme
Mots-clés Pascal anglais : Molecular epidemiology, Population survey, Sensitivity resistance, Antibacterial agent, bêta-Lactamase, Hydrolases, Enzyme, Bacteria, United States, North America, America, Septicemia, Nosocomial infection, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0529256
Code Inist : 002B02S02. Création : 13/02/1998.