Table 1. Antimicrobial Susceptibility Rates (%) for the Four Most Common Species of Gram-Negative Bacilli, 1994-2000
|
AA. E A. Escherichia coli(n=4027) |
Klebsiella pneumoniae(n=4877) |
B. Enterobacter species (n=4999) |
Pseudomonas aeruginosa(n=8244) |
Amikacin |
100 |
94 |
98 |
90 |
Tobramycin |
96 |
85 |
92 |
87 |
Gentamicin |
95 |
85 |
92 |
68 |
Piperacillin |
64 |
39 |
60 |
74 |
Piperacillin/tazobactam |
95 |
87 |
73 |
78 |
Cefepime |
98 |
90 |
84 |
71 |
Ceftazidime |
97 |
87 |
63 |
80 |
Imipenem |
100 |
99 |
99 |
83 |
Ciprofloxacin |
97 |
88 |
90 |
76 |
Table 2 Rates of Cross-Resistance (%) Among Selected Gram-Negative Bacilli, 1994-2000
|
|
|
|
|||
Antimicrobial |
% resistant (n=1946) |
% susceptible (n=6298) |
% resistant (n=486) |
% susceptible (n=4513) |
% resistant (n=603) |
% susceptible (n=4274) |
Gentamicin |
66.0 |
21.7 |
48.8 |
3.9 |
67.3 |
7.1 |
Ceftazidime |
39.8 |
14.0 |
81.5 |
31.8 |
65.2 |
6.1 |
Imipenem |
37.6 |
10.9 |
3.9 |
1.0 |
3.2 |
0.5 |
Amikacin |
26.0 |
5.6 |
10.9 |
0.8 |
32.6 |
1.8 |
Note: numbers are percentages
Table 3. Association of Previously Administered Antibiotics with Multiresistant Enterobacter in the Initial Blood Culture
Multiresistant Enterobacter |
||
Antibiotic* |
Isolate n/N (%) |
P
Value |
Any Antibiotic |
||
Yes |
36/103 (35%) |
|
No |
1/26 (4) |
.002 |
Third-generation |
||
Yes |
22/32 (69) |
|
No |
14/71 (20) |
.001 |
*Antibiotics received in the 2 weeks before the initial positive blood culture.
Data from Chow et al (7)
Table 4. Emergence of Resistance during Antibiotic Therapy for Enterobacter Bacteremia
Patient |
Antibiotic Used |
Emergence of Resistance to Drug |
MIC* before Therapy (mg/mL) |
MIC* after Therapy (mg/mL) |
Duration of Therapy When Resistance Was Seen (days) |
Source of Second Positive Culture |
Enterobacter spp. |
Outcome |
1 |
Cefotaxime |
Cefotaxime |
<4 |
>32 |
16 |
Intraabdominal
abscess |
E. cloacae |
Survived |
2 |
Ceftazidime, tobramycin |
Ceftazidime |
<2 |
>16 |
18 |
Blood |
E. cloacae |
Survived |
3 |
Ceftazidime |
Ceftazidime |
<2 |
>16 |
5 |
Blood |
E. cloacae |
Survived |
4 |
Cefotaxime, amikacin |
Cefotaxime |
< 4 |
>32 |
6 |
Blood |
E. aerogenes |
Died |
5 |
Ceftizoxime |
Ceftizoxime |
8 |
32 |
4 |
Blood |
E. cloacae |
Survived |
6 |
Cefotaxime, |
Cefotaxime |
8 |
32 |
7 |
Blood |
E. aerogenes |
Survived |
7 |
Piperacillin, tobramycin |
Tobramycin |
<0.25 |
8 |
8 |
Two Central
venous catheters |
E. cloacae |
Survived |