Bloodstream infection due to Acinetobacter spp: Epidemiology, risk factors and impact of multi-drug resistance
- Authors: Wareham, David , Bean, David , Khanna, Pooja , Hennessy, Enid , Krahe, Daniel , Ely, Andrew , Millar, Michael
- Date: 2008
- Type: Text , Journal article
- Relation: European Journal of Clinical Microbiology and Infectious Diseases Vol. 27, no. 7 (2008), p. 607-612
- Full Text: false
- Reviewed:
- Description: Acinetobacter spp. are increasingly reported as important causes of human infection. Many isolates exhibit multi-drug resistance, raising concerns over our ability to treat serious infections with these organisms. The impact of infection on clinical outcome as well as the importance of multi-drug resistance is poorly defined. A descriptive retrospective observational study was undertaken of all episodes of Acinetobacter bacteremia occurring in a UK tertiary care centre from 1998-2006. Demographics of infected patients, characteristics and antimicrobial susceptibility of infecting strains were recorded and the impact of antimicrobial therapy on all causes of 30-day mortality assessed. Three hundred ninety-nine episodes of Acinetobacter bacteremia were identified, with A. baumannii being the most frequently isolated species. Most episodes occurred in critical care and were associated with multidrug resistance, with carbapenem resistance rising from 0% in 1998 to 55% in 2006. Although bacteremia due to carbapenem-resistant Acinetobacter and a requirement for critical care were associated with a higher mortality, mortality was not reduced by the administration of appropriate empirical antimicrobial therapy. A prospective study is required to identify both the most effective intervention and those most likely to benefit from treatment.
- Description: C1
Antimicrobial resistance in community and nosocomial Escherichia coli urinary tract isolates, London 2005-2006
- Authors: Bean, David , Krahe, Daniel , Wareham, David
- Date: 2008
- Type: Text , Journal article
- Relation: Annals of Clinical Microbiology and Antimicrobials Vol. 7, no. (June 2008 2008), p.
- Full Text:
- Reviewed:
- Description: Background: Escherichia coli is the commonest cause of community and nosocomial urinary tract infection (UTI). Antibiotic treatment is usually empirical relying on susceptibility data from local surveillance studies. We therefore set out to determine levels of resistance to 8 commonly used antimicrobial agents amongst all urinary isolates obtained over a 12 month period. Methods: Antimicrobial susceptibility to ampicillin, amoxicillin/ clavulanate, cefalexin, ciprofloxacin, gentamicin, nitrofurantoin, trimethoprim and cefpodoxime was determined for 11,865 E. coli urinary isolates obtained from community and hospitalised patients in East London. Results: Nitrofurantoin was the most active agent (94% susceptible), followed by gentamicin and cefpodoxime. High rates of resistance to ampicillin (55%) and trimethoprim (40%), often in combination were observed in both sets of isolates. Although isolates exhibiting resistance to multiple drug classes were rare, resistance to cefpodoxime, indicative of Extended spectrum
- Description: C1