In vitro susceptibilities of Escherichia coli isolated from patients with intra-abdominal infections worldwide in 2002-2004: results from SMART (Study for Monitoring Antimicrobial Resistance Trends).
BACKGROUND
Since 2002, the worldwide Study for Monitoring Antimicrobial Resistance Trends (SMART) has tracked resistance patterns among aerobic and facultative gram-negative bacilli isolated from patients with intra-abdominal infections. Escherichia coli has been by far the most frequently isolated species.


METHODS
Antimicrobial susceptibilities for consecutive non-duplicate isolates of aerobic and facultative gram-negative bacilli recovered from intra-abdominal infections were determined by standard broth microdilution techniques. A subanalysis was performed for E. coli isolates from the first three years of the study.


RESULTS
A total of 7,002 E. coli isolates were recovered, most commonly from the peritoneal cavity followed by the biliary tract. Susceptibility rates to the 12 antimicrobial agents tested differed among geographic regions, with isolates from Asia/Pacific generally having the highest resistance rates. Overall, extended-spectrum beta-lactamase (ESBL)-producers had a more antibiotic-resistant profile than non-ESBL-producers but usually were susceptible to the carbapenems and amikacin. Community-acquired E. coli strains comprised slightly more than one-half of the isolates and were susceptible to the agents tested more frequently than were hospital-acquired E. coli.


CONCLUSIONS
The prevalence of antimicrobial resistance among E. coli isolated from intraabdominal infections is not inconsequential, especially in the Asia/Pacific region. The carbapenems and amikacin were consistently active in vitro against E. coli isolates worldwide, including ESBL-producers.
Bochicchio
Grant V
GV
University of Maryland Medical System, Baltimore, Maryland, USA.
Baquero
Fernando
F
Hsueh
Po-Ren
PR
Paterson
David L
DL
Rossi
Flávia
F
Snyder
Theresa A
TA
McCarroll
Kathleen
K
Satishchandran
Vilas
V
Dinubile
Mark J
MJ
Chow
Joseph W
JW
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001659:Biliary Tract / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D014943:Global Health; D006801:Humans; D008826:Microbial Sensitivity Tests; D010529:Peritoneal Cavity / Q000382:microbiology*; D011159:Population Surveillance
D000900:Anti-Bacterial Agents