title: Antimicrobial susceptibility in intensive care units: MYSTIC Program Brazil 2002.
abstract: OBJECTIVE
  Establish the susceptibility pattern of Gram-negative bacteria causing infections in ICU patients, MYSTIC Program Brazil 2002.
  
  
  METHODS
  Gram-negative bacteria (n = 503) causing nosocomial infections were collected at seven Brazilian centers. The central laboratory confirmed the identification and performed the susceptibility tests by E-test methodology (AB Biodisk, Solna, Sweden) for meropenem, imipenem, ciprofloxacin, ceftazidime, cefepime, cefotaxime, piperacillin/tazobactam, gentamicin, and tobramycin. Interpretation criteria used were according to National Committee for Clinical Laboratory Standards (NCCLS).
  
  
  RESULTS
  Pseudomonas aeruginosa (33%) was the most frequently isolated, followed by A. baumannii (17.1%), K. pneumoniae (12.1%), E. coli (10.5%), and E. cloacae (7.9%). Pseudomonas aeruginosa isolates had susceptibility rates of 67.5% to piperacillin/tazobactam, 59.8% to meropenem, 57.3% to imipenem. A. baumannii presented susceptibility rates to meropenem of 89.5%, 88.4% to imipenem, and 74.4% to tobramycin. E. coli and K. pneumoniae were fully susceptible to both carbapenems.
  
  
  CONCLUSIONS
  Carbapenem resistance among Enterobacteriaceae is still rare in this region. A. baumannii and P. aeruginosa presented elevated resistance rates to all antimicrobials. Since these two bacterial species play an important role in nosocomial infections, the use of empirical combination therapy to treat these pathogens may be justified.
authors.affiliation: Advisory Group on Antimicrobials and Clinical Microbiology, Fleury Institute, São Paulo, SP, Brazil.
authors.forename: Caio
authors.initials: C
authors.lastname: Mendes
authors.forename: Carmen
authors.initials: C
authors.lastname: Oplustil
authors.forename: Elsa
authors.initials: E
authors.lastname: Sakagami
authors.forename: Philip
authors.initials: P
authors.lastname: Turner
authors.forename: Carlos
authors.initials: C
authors.lastname: Kiffer
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001938:Brazil; D003428:Cross Infection / Q000382:microbiology*; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents