title: Antimicrobial susceptibility of Gram-negative bacteria in Brazilian hospitals: the MYSTIC Program Brazil 2003.
abstract: Establish the susceptibility pattern of Gram-negative bacteria causing infections in ICU patients, MYSTIC Program Brazil 2003. Gram-negative bacteria (n = 1,550) causing nosocomial infections were collected at 20 Brazilian centers. The central laboratory confirmed the identification and performed the susceptibility tests by Etest 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). Pseudomonas aeruginosa (30.3%) was the most frequent isolate, followed by E. coli (18.6%), Klebsiella pneumoniae (16.9%), Acitenobacter baumannii (8.8%), and Enterobacter cloacae (7.1%). Pseudomonas aeruginosa (n=470) isolates presented susceptibility rates of 64% to meropenem, 63.8% to piperacillin/tazobactam, 63.4% to amikacin, 58.7% to imipenem. Acitenobacter baumannii presented susceptibility rates to meropenem of 97.1%, and 73% to tobramycin. E. coli and K. pneumoniae were highly susceptible to both carbapenems. Carbapenem resistance among the Enterobacteriaceae is still rare in the region. Acitenobacter baumannii and P. aeruginosa presented elevated resistance rates to all antimicrobials. Since they play an important role in nosocomial infections in this environment, 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, Brazil. carlos.kiffer@fleury.com.br
authors.forename: Carlos
authors.initials: C
authors.lastname: Kiffer
authors.forename: Andre
authors.initials: A
authors.lastname: Hsiung
authors.forename: Carmen
authors.initials: C
authors.lastname: Oplustil
authors.forename: Jorge
authors.initials: J
authors.lastname: Sampaio
authors.forename: Elsa
authors.initials: E
authors.lastname: Sakagami
authors.forename: Philip
authors.initials: P
authors.lastname: Turner
authors.forename: Caio
authors.initials: C
authors.lastname: Mendes
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001938:Brazil; D003428:Cross Infection / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents