scholarly journals Temporal and Geographic Variation in Antimicrobial Susceptibility and Resistance Patterns of Enterococci: Results From the SENTRY Antimicrobial Surveillance Program, 1997–2016

2019 ◽  
Vol 6 (Supplement_1) ◽  
pp. S54-S62 ◽  
Author(s):  
Michael A Pfaller ◽  
Martin Cormican ◽  
Robert K Flamm ◽  
Rodrigo E Mendes ◽  
Ronald N Jones
Keyword(s):  
Latin American ◽  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Temporal Trends ◽  
Asia Pacific ◽  
Surveillance Program ◽  
Enterococcus Species ◽  
Medical Centers ◽  
Antimicrobial Surveillance ◽  
Tract Infections

Abstract Background The SENTRY Antimicrobial Surveillance Program was established in 1997 and presently encompasses more than 750 000 bacterial isolates from over 400 medical centers worldwide. Among these pathogens, enterococci represents a prominent cause of bloodstream (BSIs), intra-abdominal (IAIs), skin and skin structure, and urinary tract infections (UTIs). In the present study, we reviewed geographic and temporal trends in Enterococcus species and resistant phenotypes identified throughout the SENTRY Program. Methods From 1997 to 2016, a total of 49 491 clinically significant enterococci isolates (15 species) were submitted from 298 medical centers representing the Asia-Pacific (APAC), European, Latin American (LATAM), and North American (NA) regions. Bacteria were identified by standard algorithms and matrix-assisted laser desorption ionization–time of flight mass spectrometry. Susceptibility (S) testing was performed by reference broth microdilution methods and interpreted using Clinical and Laboratory Standards Institute/US Food and Drug Administration and European Committee on Antimicrobial Susceptibility Testing criteria. Results The most common Enterococcus species in all 4 regions were Enterococcus faecalis (64.7%) and E. faecium (EFM; 29.0%). Enterococci accounted for 10.7% of BSIs in NA and was most prominent as a cause of IAIs (24.0%) in APAC and of UTIs (19.8%) in LATAM. A steady decrease in the susceptibility to ampicillin and vancomycin was observed in all regions over the 20-year interval. Vancomycin-resistant enterococci (VRE) accounted for more than 8% of enterococcal isolates in all regions and was most common in NA (21.6%). Among the 7615 VRE isolates detected, 89.1% were the VanA phenotype (91.0% EFM) and 10.9% were VanB. Several newer antimicrobial agents demonstrated promising activity against VRE, including daptomycin (99.6–100.0% S), linezolid (98.0%–99.6% S), oritavancin (92.2%–98.3% S), tedizolid (99.5%–100.0% S), and tigecycline (99.4%–100.0% S). Conclusions Enterococci remained a prominent gram-positive pathogen in the SENTRY Program from 1997 through 2016. The overall frequency of VRE was 15.4% and increased over time in all monitored regions. Newly released agents with novel mechanisms of action show promising activity against VRE.

scholarly journals Antimicrobial Susceptibility of Streptococcus pneumoniae from North America, Europe, Latin America, and the Asia-Pacific Region: Results From 20 Years of the SENTRY Antimicrobial Surveillance Program (1997–2016)

2019 ◽  
Vol 6 (Supplement_1) ◽  
pp. S14-S23 ◽  
Author(s):  
Helio S Sader ◽  
Rodrigo E Mendes ◽  
Jennifer Le ◽  
Gerald Denys ◽  
Robert K Flamm ◽  
...  
Keyword(s):  
Latin America ◽  
Streptococcus Pneumoniae ◽  
North America ◽  
Antimicrobial Susceptibility ◽  
Asia Pacific ◽  
Surveillance Program ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Antimicrobial Surveillance ◽  
Tract Infections

Abstract Background The SENTRY Antimicrobial Surveillance Program monitors the frequency of occurrence and antimicrobial susceptibility of organisms from various infection types worldwide. In this investigation, we evaluated the antimicrobial susceptibility of Streptococcus pneumoniae isolates collected worldwide over 20 years (1997–2016). Methods A total of 65 993 isolates were consecutively collected (1 per infection episode) from North America (NA; n = 34 626; 2 nations), Europe (EUR; n = 19 123; 23 nations), the Asia-Pacific region (APAC; n = 7111; 10 nations), and Latin America (LATAM; n = 5133; 7 nations) and tested for susceptibility using reference broth microdilution methods. Resistant subgroups included multidrug-resistant (MDR; nonsusceptible to ≥3 classes of agents) and extensively drug-resistant (XDR; nonsusceptible to ≥5 classes). Results The isolates were collected primarily from respiratory tract infections (77.3%), and 25.4% were from pediatric patients. Penicillin susceptibility (≤0.06 mg/L) rates varied from 70.7% in EUR to 52.4% in APAC for all years combined. In NA, there was a slight improvement in susceptibility for the first few years of the program, from 66.5% in 1997–1998 to 69.4% in 1999–2000, followed by a decline until 2011–2012 (57.0%). Similar declines in penicillin susceptibility rates were observed in all regions, with the lowest rates of 67.3% in EUR (2011–2012), 41.6% in the APAC region (2007–2008), and 48.2% in LATAM (2013–2014). These declines were followed by improved susceptibility rates in all regions in later program years, with susceptibility rates of 55.6% to 71.8% in 2015–2016 (65.8% overall). Susceptibility rates to ceftriaxone, erythromycin, clindamycin, tetracycline, and trimethoprim-sulfamethoxazole followed a similar pattern, with a decrease in the first 12–14 years and a continued increase in the last 6–8 years of the program. MDR and XDR frequencies were highest in APAC (49.8% and 17.3% overall, respectively) and lowest in LATAM (10.8% and 1.9% overall, respectively). The most active agents for MDR/XDR isolates were ceftaroline (99.7%/99.1% susceptible), tigecycline (96.8%/95.9% susceptible), linezolid (100.0%/100.0% susceptible), and vancomycin (100.0%/100.0% susceptible). Conclusions S. pneumoniae susceptibility to many antibiotics increased in all regions in the last few years, and these increases may be related to PCV13 immunization, which was introduced in 2010.

scholarly journals Geographic and Temporal Patterns of Antimicrobial Resistance in Pseudomonas aeruginosa Over 20 Years From the SENTRY Antimicrobial Surveillance Program, 1997–2016

2019 ◽  
Vol 6 (Supplement_1) ◽  
pp. S63-S68 ◽  
Author(s):  
Dee Shortridge ◽  
Ana C Gales ◽  
Jennifer M Streit ◽  
Michael D Huband ◽  
Athanasios Tsakris ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Latin America ◽  
Susceptibility Testing ◽  
Temporal Trends ◽  
Bloodstream Infections ◽  
Hospitalized Patients ◽  
Asia Pacific ◽  
Surveillance Program ◽  
Medical Centers ◽  
Antimicrobial Surveillance

Abstract Background The SENTRY Antimicrobial Surveillance Program was established in 1997 and encompasses over 750 000 bacterial isolates from ≥400 medical centers worldwide. Among the pathogens tested, Pseudomonas aeruginosa remains a common cause of multidrug-resistant (MDR) bloodstream infections and pneumonia in hospitalized patients. In the present study, we reviewed geographic and temporal trends in resistant phenotypes of P. aeruginosa over 20 years of the SENTRY Program. Methods From 1997 to 2016, 52 022 clinically significant consecutive isolates were submitted from ≥200 medical centers representing the Asia-Pacific region, Europe, Latin America, and North America. Only 1 isolate per patient per infection episode was submitted. Isolates were identified by standard algorithms and/or matrix-assisted laser desorption ionization-time of flight mass spectrometry. Susceptibility testing was performed by Clinical and Laboratory Standards Institute (CLSI) methods and interpreted using CLSI and European Committee on Antimicrobial Susceptibility Testing 2018 criteria at JMI Laboratories. Results The most common infection from which P. aeruginosa was isolated was pneumonia in hospitalized patients (44.6%) followed by bloodstream infection (27.9%), with pneumonia having a slightly higher rate of MDR (27.7%) than bloodstream infections (23.7%). The region with the highest percentage of MDR phenotypes was Latin America (41.1%), followed by Europe (28.4%). The MDR rates were highest in 2005–2008 and have decreased in the most recent period. Colistin was the most active drug tested (99.4% susceptible), followed by amikacin (90.5% susceptible). Conclusions Over the 20 years of SENTRY Program surveillance, the rate of MDR P. aeruginosa infections has decreased, particularly in Latin America. Whether the trend of decreasing resistance in P. aeruginosa is maintained will be documented in future SENTRY Program and other surveillance reports.

scholarly journals High Prevalence of Oxacillin-Resistant Staphylococcus aureus Isolates from Hospitalized Patients in Asia-Pacific and South Africa: Results from SENTRY Antimicrobial Surveillance Program, 1998-1999

2002 ◽  
Vol 46 (3) ◽  
pp. 879-881 ◽  
Author(s):  
Jan M. Bell ◽  
John D. Turnidge
Keyword(s):  
South Africa ◽  
Staphylococcus Aureus ◽  
Respiratory Tract ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Asia Pacific ◽  
Surveillance Program ◽  
Antimicrobial Surveillance ◽  
Resistance Patterns ◽  
Tract Infections

ABSTRACT As part of the SENTRY antimicrobial surveillance program, we examined the prevalence rates, types, and antibiograms of oxacillin-resistant Staphylococcus aureus from hospitalized patients from 17 institutions in eight countries in Asia-Pacific and South Africa (APAC). From April 1998 to December 1999, a total of 1,711 isolates of S. aureus (814 from blood, 392 from the respiratory tract, 467 from skin and skin structures, and 38 from urine) were collected from hospitalized patients within the APAC region. Multidrug-resistant oxacillin-resistant S. aureus (MORSA) isolates, defined as strains with three or more resistances to drug classes other than β-lactams, were the most common type of oxacillin-resistant S. aureus (ORSA). They were the most frequently identified pathogen in wound infections and were common in bloodstream and lower respiratory tract infections. In all contributing institutions combined, more than 45% (range, 4 to 74%) of S. aureus isolates were oxacillin resistant, and in six institutions, this rate exceeded 60%. MORSA accounted for 91.2% of all oxacillin-resistant isolates. Distinct resistance patterns predominated at various sites within the APAC region, suggesting the local evolution of resistant clones. Non-multidrug-resistant strains were frequent in one part of Australia. No vancomycin-intermediate strains were detected, and no strains were resistant to linezolid or quinupristin-dalfopristin. MORSA strains are a very common cause of infection in hospitalized patients in the APAC region.

scholarly journals Activities of BMS 284756 (T-3811) against Haemophilus influenzae, Moraxella catarrhalis, andStreptococcus pneumoniae Isolates from SENTRY Antimicrobial Surveillance Program Medical Centers in Latin America (1999)

2001 ◽  
Vol 45 (5) ◽  
pp. 1463-1466 ◽  
Author(s):  
Ana Gales ◽  
Helio Sader ◽  
Ronald N. Jones
Keyword(s):  
Latin America ◽  
Haemophilus Influenzae ◽  
Moraxella Catarrhalis ◽  
Respiratory Tract Infections ◽  
Rank Order ◽  
Therapeutic Option ◽  
Surveillance Program ◽  
Medical Centers ◽  
Antimicrobial Surveillance ◽  
Tract Infections

ABSTRACT The antimicrobial activity of BMS 284756, a novel des-F(6)-quinolone, was comparatively evaluated against 257Streptococcus pneumoniae, 198 Haemophilus influenzae, and 88 Moraxella catarrhalis strains isolated in Latin America between July and September of 1999 as part of the SENTRY Antimicrobial Surveillance Program. Nearly 28.0% ofS. pneumoniae strains were nonsusceptible to penicillin. The rank order of quinolone potency versus S. pneumoniaewas BMS 284756 (MIC at which 90% of isolates were inhibited [MIC90], 0.12 μg/ml) > trovafloxacin (MIC90, 0.25 μg/ml) > gatifloxacin (MIC90, 0.5 μg/ml) > levofloxacin and ciprofloxacin (MIC90, 1 to 2 μg/ml). All S. pneumoniaestrains that were not susceptible to other quinolones were inhibited by BMS 284756 at ≤2 μg/ml. The overall prevalence of β-lactamase production was 15.2% in H. influenzae and 98.9% inM. catarrhalis. BMS 284756 showed excellent potency and spectrum against this group of pathogens, inhibiting all isolates at ≤0.12 μg/ml. BMS 284756 exhibited activity similar to those displayed by the new fluoroquinolones, such as levofloxacin, trovafloxacin, or gatifloxacin, and could be a therapeutic option for empirical treatment of community-acquired respiratory tract infections.

scholarly journals 1583. In Vitro Activity of Imipenem/Relebactam against Klebsiella pneumoniae and Pseudomonas aeruginosa from Patients in ICUs in the Asia/Pacific region – SMART 2015-2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S789-S789
Author(s):  
Sibylle Lob ◽  
Meredith Hackel ◽  
Wei-Ting Chen ◽  
Yivonne Khoo ◽  
Kanchan Balwani ◽  
...  
Keyword(s):  
Hong Kong ◽  
Urinary Tract ◽  
Antimicrobial Susceptibility ◽  
Bloodstream Infections ◽  
Asia Pacific ◽  
Surveillance Program ◽  
Independent Contractor ◽  
Icu Patients ◽  
Tract Infections

Abstract Background Relebactam (REL) is an inhibitor of class A and C β-lactamases approved in the USA in combination with imipenem (IMI) and cilastatin for the treatment of complicated intraabdominal and urinary tract infections. Elevated antimicrobial resistance rates have been reported in ICUs. Using isolates collected in Asia/Pacific for the SMART surveillance program, we evaluated the activity of IMI/REL and comparators against K. pneumoniae (KP) and P. aeruginosa (PA) from ICU patients. Methods In 2015-2018, 51 clinical laboratories in Australia, Hong Kong, Malaysia, New Zealand, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam each collected up to 250 consecutive aerobic gram-negative pathogens per year. Susceptibility was determined using CLSI broth microdilution and CLSI and FDA (IMI/REL) breakpoints. IMI-nonsusceptible KP and PA were screened for β-lactamase genes. Results Analyzing only the 6322 isolates from ICU patients, the 3 most common species collected were KP (21.4%), E. coli (20.5%), and PA (19.7%). Tables 1 and 2 show % susceptible and % MBL- and/or OXA-48-like-positive for the most common Enterobacterales species (KP; 70.6% from lower respiratory tract, 17.6% from intraabdominal, 7.1% from urinary tract, and 4.1% from bloodstream infections) and the most common non-Enterobacterales species (PA; 83.6%, 9.9%, 4.3%, and 1.9%, respectively). % IMI/REL-susceptible ranged from 66-79% in Thailand and Vietnam (where 13-36% of isolates carried MBL and/or OXA-48-like carbapenemases, which REL does not inhibit) to ≥95% in 6 countries (0-3% MBL- and/or OXA-48-like-positive). Among 103 IMI/REL-nonsusceptible KP isolates, 66.0% carried MBL, 20.4% OXA-48-like carbapenemases, 2.9% KPC, 2.9% acquired AmpC and/or ESBL, and in 7.8% no acquired β-lactamases were detected. Among 145 IMI/REL- nonsusceptible PA, 54.5% carried MBL, 1.4% GES carbapenemases, 4.1% only ESBL, and 40.0% no acquired β-lactamases. Table 1. Antimicrobial susceptibility of K. pneumoniae collected from ICU patients Table 2. Antimicrobial susceptibility of P. aeruginosa collected from ICU patients Conclusion IMI/REL was active against 92% of KP and 88% of PA from ICU patients in Asia/Pacific overall, with higher activity in countries with lower prevalence of MBL or OXA-48-like carbapenemases. IMI/REL provides a potential treatment option for ICU patients in Asia/Pacific with infections caused by KP and PA. Disclosures Sibylle Lob, PhD, IHMA (Employee)Pfizer, Inc. (Consultant) Wei-Ting Chen, MD, Merck, Sharp & Dohme, Taiwan (Employee) Yivonne Khoo, PhD, Merck, Sharp & Dohme, Malaysia (Employee) Kanchan Balwani, MBBS, MS, Merck, Sharp & Dohme, Hong Kong (Employee) Katherine Young, MS, Merck & Co., Inc. (Employee, Shareholder)Merck & Co., Inc. (Employee, Shareholder) Mary Motyl, PhD, Merck & Co, Inc (Employee, Shareholder) Daniel F. Sahm, PhD, IHMA (Employee)Pfizer, Inc. (Consultant)Shionogi & Co., Ltd. (Independent Contractor)

scholarly journals Antimicrobial Susceptibility of Acinetobacter calcoaceticus–Acinetobacter baumannii Complex and Stenotrophomonas maltophilia Clinical Isolates: Results From the SENTRY Antimicrobial Surveillance Program (1997–2016)

2019 ◽  
Vol 6 (Supplement_1) ◽  
pp. S34-S46 ◽  
Author(s):  
Ana C Gales ◽  
Harald Seifert ◽  
Deniz Gur ◽  
Mariana Castanheira ◽  
Ronald N Jones ◽  
...  
Keyword(s):  
Latin America ◽  
North America ◽  
Antimicrobial Susceptibility ◽  
Stenotrophomonas Maltophilia ◽  
Antimicrobial Agents ◽  
Acinetobacter Calcoaceticus ◽  
Asia Pacific ◽  
Surveillance Program ◽  
Broth Microdilution Method ◽  
Resistance Rates

Abstract Background Acinetobacter calcoaceticus–A. baumannii (Acb) complex and Stenotrophomonas maltophilia represent frequent causes of hospital-acquired infections. We evaluated the frequency and resistance rates of Acb complex and S. maltophilia isolates from medical centers enrolled in the SENTRY Program. Methods A total of 13 752 Acb complex and 6467 S. maltophilia isolates were forwarded to a monitoring laboratory by 259 participating sites from the Asia-Pacific region, Latin America, Europe, and North America between 1997 and 2016. Confirmation of species identification and antimicrobial susceptibility testing were performed using conventional methods and/or matrix-assisted laser desorption ionization–time of flight mass spectrometry and the broth microdilution method, respectively. Antimicrobial susceptibility results were interpreted by CLSI and EUCAST 2018 criteria. Results Acb complex and S. maltophilia were most frequently isolated from patients hospitalized with pneumonia (42.9% and 55.8%, respectively) and bloodstream infections (37.3% and 33.8%, respectively). Colistin and minocycline were the most active agents against Acb complex (colistin MIC50/90, ≤0.5/2 mg/L; 95.9% susceptible) and S. maltophilia (minocycline MIC50/90, ≤1/2 mg/L; 99.5% susceptible) isolates, respectively. Important temporal decreases in susceptibility rates among Acb complex isolates were observed for all antimicrobial agents in all regions. Rates of extensively drug-resistant Acb complex rates were highest in Europe (66.4%), followed by Latin America (61.5%), Asia-Pacific (56.9%), and North America (38.8%). Among S. maltophilia isolates, overall trimethoprim-sulfamethoxazole (TMP-SMX) susceptibility rates decreased from 97.2% in 2001–2004 to 95.7% in 2013–2016, but varied according to the geographic region. Conclusions We observed important reductions of susceptibility rates to all antimicrobial agents among Acb complex isolates obtained from all geographic regions. In contrast, resistance rates to TMP-SMX among S. maltophilia isolates remained low and relatively stable during the study period.

scholarly journals Haemophilus influenzae and Moraxella catarrhalis from Patients with Community-Acquired Respiratory Tract Infections: Antimicrobial Susceptibility Patterns from the SENTRY Antimicrobial Surveillance Program (United States and Canada, 1997)

1999 ◽  
Vol 43 (2) ◽  
pp. 385-389 ◽  
Author(s):  
Gary V. Doern ◽  
Ronald N. Jones ◽  
Michael A. Pfaller ◽  
Kari Kugler ◽  
Keyword(s):  
United States ◽  
Respiratory Tract ◽  
Haemophilus Influenzae ◽  
Moraxella Catarrhalis ◽  
Antimicrobial Agents ◽  
The United States ◽  
Surveillance Program ◽  
Antimicrobial Surveillance ◽  
Tract Infections ◽  
Resistance Rates

Between February and June of 1997, a large number of community-acquired respiratory tract isolates of Haemophilus influenzae (n = 1,077) and Moraxella catarrhalis (n = 503) from 27 U.S. and 7 Canadian medical centers were characterized as part of the SENTRY Antimicrobial Surveillance Program. Overall prevalences of β-lactamase production were 33.5% in H. influenzae and 92.2% in M. catarrhalis with no differences noted between isolates recovered in the United States and those from Canada. Among a total of 21 different antimicrobial agents tested, including six cephalosporins, a β-lactamase inhibitor combination, three macrolides, tetracycline, trimethoprim-sulfamethoxazole (TMP-SMX), rifampin, chloramphenicol, five fluoroquinolones, and quinupristin-dalfopristin, resistance rates of >5% with H. influenzae were observed only with cefaclor (12.8%) and TMP-SMX (16.2%).

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