title: Activity and spectrum of 22 antimicrobial agents tested against urinary tract infection pathogens in hospitalized patients in Latin America: report from the second year of the SENTRY antimicrobial surveillance program (1998).
abstract: The potency and spectrum of various antimicrobial agents tested against 434 bacterial isolates causing urinary tract infection (UTI) in hospitalized patients in Latin America were evaluated. The genotypes of the extended-spectrum beta-lactamase-producing and selected multi-resistant isolates were also evaluated by molecular typing techniques. Escherichia coli (60.4%) was the most common aetiological agent causing UTI, followed by Klebsiella spp. (11.2%) and Pseudomonas aeruginosa (8.3%). In contrast, Enterococcus spp. isolates caused only 2.3% of UTIs. Fewer than 50% of E. coli isolates were susceptible to broad-spectrum penicillins. The resistance rates to ciprofloxacin and the new quinolones were also high among these isolates. The molecular characterization of ciprofloxacin-resistant E. coli showed that most of them have a double mutation in the gyrA gene associated with a single mutation in the parC gene. The Klebsiella pneumoniae isolates studied demonstrated high resistance rates to beta-lactam drugs, including broad-spectrum cephalosporins. The carbapenems were the compounds with the highest susceptibility rate among these isolates (100.0% susceptible) followed by cefepime (91.7% susceptible). Meropenem, imipenem and cefepime were also the most active drugs against Enterobacter spp. Among P. aeruginosa isolates, meropenem (MIC(50), 2 mg/L) was the most active compound, followed by imipenem (MIC(50), 4 mg/L), cefepime (MIC(50), 8 mg/L) and ceftazidime (MIC(50), 16 mg/L). The results presented in this report confirm that bacterial resistance continues to be a great problem in Latin American medical institutions.
authors.affiliation: Medical Microbiology Division, 251 MRC, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242, USA. galesa@mail.medicine.uiowa.edu
authors.forename: A C
authors.initials: AC
authors.lastname: Gales
authors.forename: R N
authors.initials: RN
authors.lastname: Jones
authors.forename: K A
authors.initials: KA
authors.lastname: Gordon
authors.forename: H S
authors.initials: HS
authors.lastname: Sader
authors.forename: W W
authors.initials: WW
authors.lastname: Wilke
authors.forename: M L
authors.initials: ML
authors.lastname: Beach
authors.forename: M A
authors.initials: MA
authors.lastname: Pfaller
authors.forename: G V
authors.initials: GV
authors.lastname: Doern
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000890:Anti-Infective Agents / Q000494:pharmacology; D000892:Anti-Infective Agents, Urinary / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D018432:Drug Resistance, Multiple; D024841:Fluoroquinolones; D006760:Hospitalization; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology*; D001618:beta-Lactamases / Q000096:biosynthesis / Q000235:genetics; D047090:beta-Lactams
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000892:Anti-Infective Agents, Urinary; D024841:Fluoroquinolones; D047090:beta-Lactams; D001618:beta-Lactamases