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Susceptibility to Cephalosporins and Fluoroquinolones among Enterobacteriaceae Isolated From Lower Respiratory Tract Infections (TSN Database-USA, 1998–2002): Implications for Empiric Therapy FREE TO VIEW

Mark E. Jones, PhD; Deborah C. Draghi, BS; Clyde Thornsberry, PhD; James A. Karlowsky, PhD; Daniel F. Sahm, PhD
Author and Funding Information

Focus Technologies, Herndon, VA


Chest. 2003;124(4_MeetingAbstracts):96S. doi:10.1378/chest.124.4_MeetingAbstracts.96S-a
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PURPOSE:  Trends in antibiotic resistance (R) among cephalosporins (CPH) and fluoroquinolones (FQ) were investigated for Enterobacteriaceae (EB) isolated from lower respiratory tract infections (LRTI). Antimicrobial resistance among pathogens causing pneumoniae could negatively affect the success of empiric treatment.

METHODS:  Data from ‘98-’02 was analyzed from The Surveillance Network (TSN®) Database USA, an electronic surveillance system that collects routine susceptibility results as reported to physicians from >300 US hospitals. Ceftriaxone (CTX) and ciprofloxacin (CIP), used as markers for parenteral CPH and FQ, were tested against EB from LRTI specimens from adult (>=18 yrs) inpatients (IN), intensive-care patients (ICU), or outpatients (OT). NCCLS 2002 breakpoints were utilized.

RESULTS:  K. pneumoniae (KP, n =9,737), E. coli (EC, n =11,564) and S. marcescens (SM, n =12,291) comprised the most common EB isolated and tested. R rates are listed for IN, ICU, and OT, respectively. For KP R rates (%) for CTX were 2.1, 2.3, and 3.9 in ‘98 to 2.7, 4.6, and 5.2 in ‘02; R rates for CIP were 6.2, 7.4, and 9.8 in ‘98 to 8.4, 10.6, and 13.4 in ’02. For EC R rates (%) for CTX were 1.2, 1.6, and 0 in ‘98 to 4.3, 2.2, and 3.7 in ’02; R rates for CIP were 7.8, 3.4, and 7.7 in ‘98 to 27.6, 20.4, and 26.5 in ‘02. For SM R rates (%) for CTX were 3.7, 1.8, 1.9 in ‘98 to 4.1, 2.9, and 3.5 in ’02; R rates for CIP were 7.3, 4.1, and 12.1 in ‘98 to 14.9, 8.2, and 10.2 in ’02.CONCLUSIONS: The prevalence of R to CTX remains relatively low for EB; slight increases were noted. Overall, the prevalence of R to CIP was higher than CTX, especially for EC, where the R rate to CIP exceeded 20%.

CLINICAL IMPLICATIONS:  The rapid emergence of FQ R, especially in EC may impact the efficacy of this compound class and its role as a therapeutic agent in treating LRTI.

DISCLOSURE:  M.E. Jones, sponsored by Roche Laboratories, Industry.

Tuesday, October 28, 2003

10:30 AM - 12:00 PM




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