title: In vitro susceptibilities of aerobic and facultatively anaerobic Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends).
abstract: OBJECTIVE
  SMART (Study for Monitoring Antimicrobial Resistance Trends) is an ongoing study to monitor worldwide antimicrobial resistance trends among aerobic and facultatively anaerobic Gram-negative bacilli (GNB) isolated from intra-abdominal infections. This 2004 report summarizes the most recently completed annual data from SMART.
  
  
  METHODS
  During 2004, 81 medical centres from 28 countries in five global regions collected intra-abdominal GNB for antimicrobial susceptibility testing using broth microdilution according to the Clinical and Laboratory Standards Institute guidelines.
  
  
  RESULTS
  A total of 6156 unique aerobic and facultatively anaerobic GNB were isolated from intra-abdominal infections. Enterobacteriaceae composed 86% of the total isolates. Among the 12 antimicrobial agents tested, the carbapenems and amikacin were the most consistently active against the Enterobacteriaceae. Escherichia coli was the most commonly isolated species (48%), and the susceptibility rate to the quinolones was lowest in Asia/Pacific and Latin America. Extended-spectrum beta-lactamases (ESBLs) were detected phenotypically in 10% of E. coli, 17% of Klebsiella spp. and 22% of Enterobacter spp. worldwide, representing a slight increase over the two previous years. ESBL producers typically had a more antibiotic-resistant profile than non-ESBL producers but were usually susceptible to the carbapenems.
  
  
  CONCLUSIONS
  Antimicrobial resistance among GNB isolated from intra-abdominal infections continued to be a problem worldwide in 2004, with the highest rates of resistance overall in the Asia/Pacific region. The carbapenems and amikacin were the most consistently active agents in vitro against Enterobacteriaceae isolated from intra-abdominal infections worldwide.
authors.affiliation: Hospital das Clinicas da Faculdade de Medicina, São Paulo LIM 03, Brazil.
authors.forename: Flávia
authors.initials: F
authors.lastname: Rossi
authors.forename: Fernando
authors.initials: F
authors.lastname: Baquero
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
authors.forename: David L
authors.initials: DL
authors.lastname: Paterson
authors.forename: Grant V
authors.initials: GV
authors.lastname: Bochicchio
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Snyder
authors.forename: Vilas
authors.initials: V
authors.lastname: Satishchandran
authors.forename: Kathleen
authors.initials: K
authors.lastname: McCarroll
authors.forename: Mark J
authors.initials: MJ
authors.lastname: DiNubile
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Chow
mesh_terms: D000005:Abdomen / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents