1535. Susceptibility Profiles of Gram-Negative Bacilli Associated with Intra-Abdominal Infections (IAI) in Latin American Countries, SMART 2013-2014
Session: Poster Abstract Session: Clinical Infectious Diseases: Soft Tissue Infections (ABSSSIs)
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • Merck_P37_IAI ESBL Central America_IDSA 2015_v01_final [Read-Only].pdf (194.8 kB)
  • Background: Gram-negative pathogens isolated from patients with IAI cause significant treatment problems. The production of ESBLs by Enterobacteriaceae limits the use of many β-lactams. Isolates that carry an ESBL also often have co-resistance mechanisms to other antimicrobial classes. In addition, regional variations in susceptibility patterns can cause difficulty when selecting appropriate empirical antimicrobial therapy for IAI. In this study data from Study for Monitoring Antimicrobial Resistance Trends (SMART) program 2013-2014 were used to determine antimicrobial susceptibility patterns among patients with IAI in Ecuador, Guatemala, Mexico, and Panama. Methods: E. coli (EC), K. pneumoniae/K. oxytoca (combined as KPO), and P. mirabilis (PM) isolates were identified and susceptibility tested using broth microdilution according to CLSI guidelines. ESBL rates were determined by CLSI definitions and using CLSI breakpoint criteria to define susceptibility rates. Results : Susceptibility rates by country are shown in the table.

    Country (n)/%S (EC/KPO/PM)a

    Drug

    Ecuador (78)

    Guatemala (292)

    Mexico (383)

    Panama (261)

     

    Ceftazidime

    78.8/50.0/-

    65.5/69.0/87.5

    37.6/59.6/100

    81.8/70.2/88.2

     

    Ceftriaxone

    71.2/50.0/-

    62.4/60.3/75.0

    33.0/55.8/100

    77.0/71.9/76.5

     

    Cefepime

    75.8/50.0/-

    63.3/63.8/75.0

    36.4/55.8/100

    81.3/73.7/88.2

     

    Pip-tazo

    93.9/66.7/-

    90.3/81.0/100

    88.1/92.3/100

    94.1/80.7/100

     

    Ertapenem

    98.5/75.0/-

    99.6/91.4/100

    99.2/99.0/100

    99.5/93.0/100

     

    Imipenem

    98.5/83.3/-

    99.6/91.4/75.0

    99.6/97.1/27.8

    100/93.0/29.4

     

    Levofloxacin

    60.6/66.7/-

    54.4/86.2/75.0

    32.2/87.5/94.4

    63.1/75.4/88.2

     

    Amikacin

    98.5/91.7/-

    98.2/96.6/100

    98.1/99.0/100

    99.5/93.0/100

     

    a Dash indicates no isolates tested.

    ESBL rates in both years combined for EC/KPO/PM were 24/42/-% (Ecuador), 37/31/25% (Guatemala), 64/43/0% (Mexico), and 19/28/12% (Panama), respectively.

    Conclusion:   The relatively high rates of resistance exhibited by these three organism groups of Enterobacteriaceae causing IAI varied among the four Latin American countries studied.  The ESBLs rates were also high.  These findings underscore the importance of continued and careful monitoring of antimicrobial activities against the key pathogens associated with IAI.

    Griselda Hernandez-Tepichin, MD1, Aaron Johnson, BS2, Douglas Biedenbach, MS2, Robert Badal, BS2 and Dan Sahm, PhD2, (1)Merck & Co., Inc., AB-AF Latin America Medical Director, Colonia La Otra Banda, Mexico, (2)International Health Management Associates, Inc., Schaumburg, IL

    Disclosures:

    G. Hernandez-Tepichin, Merck & Co., Inc.: Employee , Salary

    A. Johnson, IHMA, Inc.: Independent Contractor , Consulting fee

    D. Biedenbach, IHMA, Inc.: Independent Contractor , Consulting fee

    R. Badal, IHMA, Inc.: Independent Contractor , Consulting fee

    D. Sahm, IHMA, Inc.: Independent Contractor , Consulting fee

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.