- Meeting abstract
In vitro activity of imipenem ± aminoglycosides against Pseudomonas aeruginosa and Acinetobacter calcoaceticus / baumanii isolated from patients in ICUs in German hospitals (1999–2002)
Critical Care volume 7, Article number: P126 (2003)
Carbapenems such as imipenem (IM) provide important antimicrobial activities against Pseudomonas aeruginosa (PA) and Acinetobacter calcoaceticus/baumanii (ACB). Additionally co-administration with an aminoglycoside provides broad-spectrum coverage. The current activity of IM, and the activity of IM and gentamicin (GN) or amikacin (AK), considered together, was reviewed by analysis of cross-susceptibility to this combination, as reported to physicians, by clinical microbiology laboratories in Germany.
Data were analyzed (January 1999-October 2002) from The Surveillance Network® (TSN) Database Germany, an electronic surveillance system that collects routine susceptibility test results from 169 hospital laboratories distributed throughout the country. Only data from nonrepeat isolates from patients > 17 years of age, located on ICUs, and derived from antibiotics concomitantly tested were included in the analysis. NCCLS (2002) breakpoints were used to interpret the data.
For all PA (n = 1316) isolated from lower respiratory tract infection (LRTI) specimens during 1999–2000, 65.3% were reported susceptible (S) and 20.9% resistant (R) to IM. The following susceptibility and resistance frequencies were found for PA from LRTI, reported by year: 1999 (n = 127; 65.4% S; 31.5% R), 2000 (n = 346; 66.5% S; 28.9% R), 2001 (n = 539; 63.5% S; 15.4% R), and 2002 (n = 304; 67.1% S; 17.1% R). Among PA from blood reported by year: 1999 (n = 7; 85.7% S; 14.3% R), 2000 (n = 20; 80.0% S; 15.0% R), 2001 (n = 31; 74.2% S; 16.1% R), and 2002 (n = 39; 84.6% S; 12.8% R). Considering data of IM combined with an aminoglycoside, for PA from LRTI isolated during 2000–2002, 86.3% of isolates were S (n = 1634; 5.8% R) to both IM and gentamicin (GT), and 93.8% of isolates were S (n = 1171; 2.8% R) to IM and AK. PA isolates from blood were 89.1% S (n = 64; 3.1% R) to the combination of IM and GT, and 100% S (n = 45) to the combination of IM and AK. Overall (2000–2002) for ACB isolated from LRTI, 98.2% were S (n = 225; 0% R) compared with 100% S (n = 25) for blood isolates. For ACB by year, the following IM susceptibility percentages were detected: 90.5% S in 2000 (n = 21; 9.5% R), 99.3% S in 2001 (n = 143; 0.7% R), and 97.5% S in 2002 (n = 163; 0% R).
In Germany, IM susceptibility has remained consistent for PA since 1999 and ACB since 2000, and no increase in resistant phenotypes was detected. Combinations of IM with an aminoglycoside still approach 100% coverage against PA.
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Mueller, E., Stek, M., Draghi, D. et al. In vitro activity of imipenem ± aminoglycosides against Pseudomonas aeruginosa and Acinetobacter calcoaceticus / baumanii isolated from patients in ICUs in German hospitals (1999–2002). Crit Care 7, P126 (2003). https://doi.org/10.1186/cc2015
- Pseudomonas Aeruginosa
- Lower Respiratory Tract Infection