title: In vitro efficacy of six cephalosporins tested against Enterobacteriaceae isolated at 38 North American medical centres participating in the SENTRY Antimicrobial Surveillance Program, 1997-1998.
abstract: The SENTRY Antimicrobial Surveillance Program is an ongoing international collaboration that monitors the predominant bacterial and fungal pathogens and antimicrobial susceptibility patterns associated with community-acquired and nosocomial infections. SENTRY data on the current cephalosporin susceptibility patterns (1997-98) of North American isolates of clinically important Enterobacteriaceae were analyzed. Susceptibility to a selection of cephalosporins was assessed at a central laboratory using reference broth microdilution methods and interpretive criteria specified by the National Committee for Clinical Laboratory Standards. The third- and fourth-generation cephalosporins tested demonstrated excellent activity against Escherichia coli and Klebsiella pneumoniae, whereas some of the older agents maintained good efficacy. Extended spectrum beta-lactamases were detected in all regions of the United States and Canada (1.8-10.7%). Cefepime was the most active agent tested against pathogens with the potential for enzyme-mediated resistance due to Amp C. The third-generation agents maintained acceptable efficacy against Serratia marcescens, but were less effective against Citrobacter and Enterobacter species. The older cephalosporins were generally inadequate against these pathogens, in contrast to cefepime, which was the widest spectrum cephalosporin overall. Some significant regional variations in spectrum were detected.
authors.affiliation: Department of Pathology, Medical Microbiology Division, C606GH, University of Iowa College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA. ronald-jones@uiowa.edu
authors.forename: R N
authors.initials: RN
authors.lastname: Jones
authors.forename: S G
authors.initials: SG
authors.lastname: Jenkins
authors.forename: D J
authors.initials: DJ
authors.lastname: Hoban
authors.forename: M A
authors.initials: MA
authors.lastname: Pfaller
authors.forename: R
authors.initials: R
authors.lastname: Ramphal
mesh_terms: D000077723:Cefepime; D002511:Cephalosporins / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D002954:Citrobacter / Q000187:drug effects; D004352:Drug Resistance, Microbial; D004754:Enterobacter / Q000187:drug effects; D004755:Enterobacteriaceae / Q000187:drug effects*; D004926:Escherichia coli / Q000187:drug effects; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects; D008826:Microbial Sensitivity Tests; D015337:Multicenter Studies as Topic; D009656:North America; D012706:Serratia marcescens / Q000187:drug effects; D013045:Species Specificity; D001618:beta-Lactamases / Q000494:pharmacology
chemical_list: D002511:Cephalosporins; D000077723:Cefepime; D001618:beta-Lactamases