E A Bryce1, W D Colby, J Haket, M W Poisson, J A Smith. 1. Division of Medical Microbiology, Department of Pathology, Vancouver Hospital, Vancouver, British Columbia; Division of Microbiology, University Hospital and University of Western Ontario, London, Ontario; Merck Frosst Canada Inc, Kirkland, Quebec; and Department of Microbiology and Infectious Disease, Hôtel-Dieu, Montreal, Quebec.
Abstract
OBJECTIVE: To assess the prevalence of antibiotic resistance in Canadian intensive care units. DESIGN: The antimicrobial profiles of 1939 Gram-negative bacilli isolated in 20 Canadian intensive care units were analyzed using a custom designed MicroScan panel. SETTING: The majority of the hospitals were tertiary care institutions, but some community hospitals were included. PATIENTS: Adult intensive care unit patients were the sources of isolates. MAIN RESULTS: Pseudomonas aeruginosa was the most frequently isolated microorganism overall, with Escherichia coli the most common initial isolate. Comparison of initial and repeat isolates showed that P aeruginosa readily acquired resistance to all antibiotic classes except the aminoglycosides. Enterobacter aerogenes developed resistance to ciprofloxacin and Enterobacter cloacae demonstrated resistance to all beta-lactam antibiotics except for imipenem on repeat isolation. Other Enterobacteriaceae remained susceptible. Historical comparison with data derived four years previously from 15 of the centres showed increased resistance of P aeruginosa and Acinetobacter species to ciprofloxacin while other susceptibility patterns remained stable. CONCLUSIONS: The prevalence of Gram-negative resistance in Canadian hospitals is less than that reported in surveys done in some other countries, and was relatively stable over four years.
OBJECTIVE: To assess the prevalence of antibiotic resistance in Canadian intensive care units. DESIGN: The antimicrobial profiles of 1939 Gram-negative bacilli isolated in 20 Canadian intensive care units were analyzed using a custom designed MicroScan panel. SETTING: The majority of the hospitals were tertiary care institutions, but some community hospitals were included. PATIENTS: Adult intensive care unit patients were the sources of isolates. MAIN RESULTS:Pseudomonas aeruginosa was the most frequently isolated microorganism overall, with Escherichia coli the most common initial isolate. Comparison of initial and repeat isolates showed that P aeruginosa readily acquired resistance to all antibiotic classes except the aminoglycosides. Enterobacter aerogenes developed resistance to ciprofloxacin and Enterobacter cloacae demonstrated resistance to all beta-lactam antibiotics except for imipenem on repeat isolation. Other Enterobacteriaceae remained susceptible. Historical comparison with data derived four years previously from 15 of the centres showed increased resistance of P aeruginosa and Acinetobacter species to ciprofloxacin while other susceptibility patterns remained stable. CONCLUSIONS: The prevalence of Gram-negative resistance in Canadian hospitals is less than that reported in surveys done in some other countries, and was relatively stable over four years.
Entities:
Keywords:
Antibiotics; Intensive care units; Resistance
Authors: W R Jarvis; J R Edwards; D H Culver; J M Hughes; T Horan; T G Emori; S Banerjee; J Tolson; T Henderson; R P Gaynes Journal: Am J Med Date: 1991-09-16 Impact factor: 4.965