1174. Global Susceptibility Trends and Extended Spectrum Beta-lactamase (ESBL) Rates Among Proteus mirabilis: Results of the SMART 2010-2014 Analysis
Session: Poster Abstract Session: Resistance Mechanisms
Friday, October 9, 2015
Room: Poster Hall
Posters
  • Merck P34_P mirabilis_Global_ESBL_IDSA 2015_V01_final [Read-Only].pdf (188.1 kB)
  • Background: P.mirabilis plays a significant role in both intra-abdominal (IAI) and urinary tract infections (UTI). Treatment options are increasingly limited due to increased resistance among various enteric species. This study focused on resistance patterns associated specifically with P. mirabilis and evaluated the in vitro activity of ertapenem and comparators against P. mirabilis, including ESBL-positive populations Methods: From 2010-2014 4,835 P. mirabilis isolates were obtained from patients with IAI and UTI.  The patients were from SMART surveillance program sites distributed globally. MICs were determined by the central reference laboratory using supplied microdilution panels and interpreted according to CLSI guidelines. Results: % susceptibility of ertapenem and comparators and ESBL rates are shown in the table below.

    %S (All, ESBL+, ESBL-)

    2010

    2011

    2012

    2013

    2014

    N (all, ESBL+, -)

    % ESBL

    872/53/819

    6.1

    925/99/826

    10.7

    1048/104/944

    9.9

    1054/120/934

    11.4

    936/74/862

    7.9

    Amikacin

    98.3/86.8/99.0

    96.9/83.8/98.4

    96.6/84.6/97.9

    95.5/78.3/97.8

    98.1/81.1/99.5

    Amp-Sulbactam

    73.7/15.1/77.5

    70.7/23.2/76.4

    70.6/22.1/76.0

    71.3/25.0/77.2

    75.6/35.1/79.2

    Cefepime

    94.2/17.0/99.2

    83.6/20.2/91.2

    88.6/15.4/96.6

    88.3/20.0/97.1

    92.1/9.5/99.2

    Cefoxitin

    94.5/88.7/94.9

    94.4/87.9/95.2

    93.4/88.5/94.0

    92.2/81.7/93.6

    94.8/89.2/95.2

    Ceftriaxone

    87.7/9.4/92.8

    85.5/19.2/93.5

    85.5/8.7/94.0

    85.5/16.7/94.3

    89.1/9.5/96.0

    Ciprofloxacin

    73.5/20.8/76.9

    70.6/30.3/75.4

    70.2/25.0/75.2

    71.1/18.3/77.8

    70.0/17.6/74.5

    Ertapenem

    99.9/100/99.9

    99.5/99.0/99.5

    99.9/99.0/100

    99.8/98.3/100

    100/100/100

    Imipenem

    28.1/34.0/27.7

    19.1/20.2/19.0

    16.7/13.5/17.1

    26.9/20.0/27.8

    24.3/27.0/24.0

    Levofloxacin

    82.7/34.0/85.8

    81.5/45.6/85.8

    78.9/37.5/83.5

    80.3/30.8/86.6

    81.4/32.4/85.6

    Pip-Tazo

    99.0/96.2/99.2

    94.6/90.0/95.2

    98.2/94.2/98.6

    99.0/97.5/99.1

    99.7/100/99.7

               

    Conclusion:

    Over the 5 year study period ertapenem exhibited consistent (>99% susceptible) activity against both ESBL-positive and -negative P. mirabilis. Amikacin and piperacillin-tazobactam were active against ESBL negative isolates, but exhibited diminished activity against ESBL phenotypes. ESBL rates affect antimicrobial activity of many antimicrobials used to treat IAI and UTI where P. mirabilis is a causative pathogen.

    Daryl Hoban, PhD, Douglas Biedenbach, MS, Meredith Hackel, PhD, MPH and Dan Sahm, PhD, International Health Management Associates, Inc., Schaumburg, IL

    Disclosures:

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

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

    M. Hackel, IHMA, Inc.: Independent Contractor , Consulting fee

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

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