Antimicrobial Susceptibility of Gram-Negative ESKAPE Pathogens Isolated from Hospitalized Patients with Intra-Abdominal and Urinary Tract Infections in Asia-Pacific Countries: SMART 2013-2015.
J Med Microbiol. 2017 Jan 03;:
Authors: Karlowsky JA, Hoban DJ, Hackel MA, Lob S, Sahm DF
Gram-negative ESKAPE pathogens (Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) are responsible for increases in antimicrobial-resistant infections worldwide. We determined in vitro susceptibilities to eight parenteral antimicrobial agents using CLSI broth microdilution methodology for gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal infections (IAI) (n = 3,052) and urinary tract infections (UTI) (n = 1,088) in 11 countries/regions from 2013-2015. Amikacin (98.3%, 96.4%), imipenem (97.1%, 95.5%), and ertapenem (95.3%, 93.2%) demonstrated the highest rates of susceptibility for isolates of K. pneumoniae from IAI and UTI, respectively, whereas susceptibility to advanced-generation cephalosporins was <84% and <71%, respectively. K. pneumoniae with an ESBL-positive phenotype were more common in UTI (27.1%) than IAI (16.2%). Imipenem and amikacin were the most active agents against ESBL-positive K. pneumoniae from IAI (95.1%, 91.8%) and UTI (94.9%, 92.3%), respectively; whereas <54% were susceptible to piperacillin-tazobactam. Against Enterobacter spp. and P. aeruginosa, amikacin demonstrated the highest rates of susceptibility for isolates from IAI (99.7%, 95.5%) and UTI (90.9%, 91.5%), respectively. K. pneumoniae, Enterobacter spp., and P. aeruginosa from urine demonstrated lower susceptibility to levofloxacin (74.1%, 81.8%,73.8%) than from IAI (87.6%, 91.8%, 85.4%). For A. baumannii, rates of susceptibility to all agents tested were <43%. We conclude that the studied gram-negative ESKAPE pathogens demonstrated reduced susceptibility to commonly prescribed advanced-generation cephalosporins, piperacillin-tazobactam, and levofloxacin, while amikacin and carbapenems were the most active. Ongoing surveillance to monitor evolving resistance trends and the development of novel antimicrobial agents with potent activity against gram-negative ESKAPE pathogens are mandatory.
PMID: 28051952 [PubMed - as supplied by publisher]