title: In vitro susceptibilities of aerobic and facultatively anaerobic gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2005 results from Study for Monitoring Antimicrobial Resistance Trends (SMART).
abstract: BACKGROUND
  The Study for Monitoring Antimicrobial Resistance Trends (SMART) is examining aerobic and facultatively anaerobic gram-negative bacilli (GNB) isolated from intra-abdominal infections. This report summarizes the 2005 annual data.
  
  
  METHODS
  During 2005, 76 medical centers in 31 countries in five 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 5,476 unique aerobic and facultatively anaerobic GNB were isolated. Enterobacteriaceae accounted for 86% (4,711) of the total isolates. Among the 12 antimicrobial agents tested, the carbapenems and amikacin were the most reliably active against the Enterobacteriaceae, whereas ampicillin/sulbactam most often was the least active. Escherichia coli was the species most commonly isolated, at 48% (2,654). Extended-spectrum beta-lactamases (ESBLs) were detected phenotypically in 12% (325/2,329) of E. coli and 18% (151/856) of Klebsiella spp. In general, ESBL producers demonstrated lower susceptibility to the majority of the antibiotics than the non-producers; however, ESBL producers usually were susceptible to the carbapenems tested.
  
  
  CONCLUSIONS
  In 2005, antibiotic resistance continued to be a problem among GNB isolated from intra-abdominal infections, with the highest resistance rates observed in the Asia/Pacific region. Imipenem-cilastatin, ertapenem, and amikacin were the agents most consistently active in vitro against the Enterobacteriaceae isolated.
authors.affiliation: Hospital Ramon y Cajal, Madrid, Spain.
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: Flávia
authors.initials: F
authors.lastname: Rossi
authors.forename: Grant V
authors.initials: GV
authors.lastname: Bochicchio
authors.forename: Gale
authors.initials: G
authors.lastname: Gallagher
authors.forename: Keith
authors.initials: K
authors.lastname: Lantz
authors.forename: Javier Baez
authors.initials: JB
authors.lastname: Villasenor
authors.forename: Kathleen
authors.initials: K
authors.lastname: McCarroll
authors.forename: Murray A
authors.initials: MA
authors.lastname: Abramson
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Chow
mesh_terms: D034841:Abdominal Cavity / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects; D014943:Global Health; D006088:Gram-Negative Aerobic Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006092:Gram-Negative Facultatively Anaerobic Rods / Q000187:drug effects*; D006801:Humans; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents