title: Ability of laboratories to detect emerging antimicrobial resistance in nosocomial pathogens: a survey of project ICARE laboratories.
abstract: A proficiency testing project was conducted among 48 microbiology laboratories participating in Project ICARE (Intensive Care Antimicrobial Resistance Epidemiology). All laboratories correctly identified the Staphylococcus aureus challenge strain as oxacillin- resistant and an Enterococcus faecium strain as vancomycin-resistant. Thirty-one (97%) of 32 laboratories correctly reported the Streptococcus pneumoniae strain as erythromycin-resistant. All laboratories testing the Pseudomonas aeruginosa strain against ciprofloxacin or ofloxacin correctly reported the organism as resistant. Of 40 laboratories, 30 (75%) correctly reported resistant MICs or zone sizes for the imipenem- and meropenem-resistant Serratia marcescens. For the extended-spectrum beta-lactamase (ESBL)-producing strain of Klebsiella pneumoniae, 18 (42%) of 43 laboratories testing ceftazidime correctly reported ceftazidime MICs in the resistant range. These results suggest that current testing generally produces accurate results, although some laboratories have difficulty detecting resistance to carbapenems and extended-spectrum cephalosporins. This highlights the need for monitoring how well susceptibility test systems in clinical laboratories detect emerging resistance.
authors.affiliation: Hospital Infections Program, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE (G08) Atlanta, GA 30333, USA. cks7@cdc.gov
authors.forename: C D
authors.initials: CD
authors.lastname: Steward
authors.forename: D
authors.initials: D
authors.lastname: Wallace
authors.forename: S K
authors.initials: SK
authors.lastname: Hubert
authors.forename: R
authors.initials: R
authors.lastname: Lawton
authors.forename: S K
authors.initials: SK
authors.lastname: Fridkin
authors.forename: R P
authors.initials: RP
authors.lastname: Gaynes
authors.forename: J E
authors.initials: JE
authors.lastname: McGowan
authors.forename: F C
authors.initials: FC
authors.lastname: Tenover
mesh_terms: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000890:Anti-Infective Agents / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control; D004352:Drug Resistance, Microbial; D016984:Enterococcus faecium / Q000187:drug effects; D004917:Erythromycin / Q000494:pharmacology; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D007755:Laboratories, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D000077731:Meropenem; D015242:Ofloxacin / Q000494:pharmacology; D010068:Oxacillin / Q000494:pharmacology; D010406:Penicillins / Q000494:pharmacology; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D015203:Reproducibility of Results; D012706:Serratia marcescens / Q000187:drug effects; D013211:Staphylococcus aureus / Q000187:drug effects; D013296:Streptococcus pneumoniae / Q000187:drug effects; D013845:Thienamycins / Q000494:pharmacology; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D010406:Penicillins; D013845:Thienamycins; D002939:Ciprofloxacin; D004917:Erythromycin; D014640:Vancomycin; D015378:Imipenem; D015242:Ofloxacin; D000077731:Meropenem; D010068:Oxacillin