Frequency of occurrence and antimicrobial susceptibility of Gram-negative bacteremia isolates in patients with urinary tract infection: results from United States and European hospitals (2009-2011)

J Chemother. 2014 Jun;26(3):133-8. doi: 10.1179/1973947813Y.0000000121. Epub 2013 Dec 6.

Abstract

We evaluated the frequency of occurrence and antimicrobial susceptibility patterns of Gram-negative bacteria isolated from bacteremic patients with UTI from European (EU) and United States (USA) hospitals during a 3-year period (2009-2011). Susceptibility testing was performed by the reference broth microdilution method on 2071 Gram-negative bacilli. The most frequently isolated pathogens were Escherichia coli (63·3/71·3% in USA/EU), Klebsiella spp. (16·7/11·2%) and Proteus mirabilis (6·4/5·0%). Escherichia coli susceptibility rates were generally similar in the USA and EU, with extended-spectrum beta-lactamase (ESBL)-phenotype rates at 8·1% in both regions. Among Klebsiella spp., ESBL rates varied from 11·4/17·1% in 2009 to 16·1/40·4% in 2011 in USA/EU, and susceptibility rates were generally lower in EU compared to the USA. Pseudomonas aeruginosa exhibited lower susceptibility rates to ceftazidime, meropenem and piperacillin/tazobactam in EU (78·4, 78·4 and 76·5%, respectively) compared to USA (91·2, 88·2 and 91·2%, respectively). In summary, very few antimicrobials provided satisfactory coverage (>90%) when tested against Klebsiella spp. and P. aeruginosa isolates in EU.

Keywords: Antimicrobial resistance,; ESBL,; Escherichia coli,; Klebsiella spp.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteremia / drug therapy
  • Bacteremia / epidemiology*
  • Drug Resistance, Microbial*
  • Enterobacter
  • Escherichia coli
  • Europe / epidemiology
  • Gram-Negative Bacteria
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / epidemiology*
  • Hospitals / statistics & numerical data
  • Humans
  • Klebsiella
  • Microbial Sensitivity Tests
  • Proteus mirabilis
  • Pseudomonas aeruginosa
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
  • United States / epidemiology
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / microbiology*