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Contemporary activity of meropenem and comparator broad-spectrum agents: MYSTIC program report from the United States component (2005).
Diagn Microbiol Infect Dis. 2007 Feb; 57(2):207-15.DM

Abstract

The Meropenem Yearly Susceptibility Test Information Collection Program is a 9-year-old antimicrobial resistance surveillance network of more than 100 medical centers worldwide, including 15 sites in the United States (US) that monitors the susceptibility of Gram-negative and Gram-positive bacterial pathogens especially to carbapenems. In 2005, the antimicrobial activity of 11 broad-spectrum agents was assessed against 2910 bacterial isolates (2493 Gram-negative and 417 staphylococci) submitted from the US medical centers to a reference laboratory using Clinical and Laboratory Standards Institute susceptibility testing methods and interpretative criteria. Meropenem continued to demonstrate 1) high potency with MIC(90) values 4- to 16-fold lower than imipenem against the Enterobacteriaceae, 2) equal activity against Pseudomonas aeruginosa, 3) 2-fold less activity compared with imipenem against Acinetobacter spp., and 4) 4- to 8-fold less activity compared with imipenem against the oxacillin-susceptible staphylococci. The wide spectrum of activity for carbapenems against Enterobacteriaceae (1657 strains) was confirmed by the overall rank order by percentage susceptibility at breakpoint criteria: imipenem (98.9%) > meropenem (98.7%) > cefepime (97.6%) > piperacillin/tazobactam (92.0%) > ceftriaxone (91.2%) > aztreonam (90.6%) > gentamicin = tobramycin (90.5%) > ceftazidime (90.4%) > levofloxacin (84.9%) > ciprofloxacin (83.9%). Against Acinetobacter spp. isolates, only tobramycin (92.0% susceptible) and carbapenems (92.0-85.6%) exhibited acceptable levels of activity. A continued increase in the resistance rate for both ciprofloxacin and levofloxacin was observed with highest rates found among indole-positive Proteae species (36.5-33.3%) and Escherichia coli (21.6-20.4%) isolates, some documented by molecular typing methods as clonally related. Ongoing surveillance of meropenem and other broad-spectrum antimicrobial agents appears warranted to monitor the potency and spectrum of activity against indicated Gram-negative and-positive pathogens causing serious infections in the hospital setting, and to detect the emergence of new or novel resistance mechanisms that could compromise clinical utility (serine and metallo-carbapenemases).

Authors+Show Affiliations

JMI Laboratories, North Liberty, IA 52317, USA. paul-rhomberg@jmilabs.comNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16949243

Citation

Rhomberg, Paul R., and Ronald N. Jones. "Contemporary Activity of Meropenem and Comparator Broad-spectrum Agents: MYSTIC Program Report From the United States Component (2005)." Diagnostic Microbiology and Infectious Disease, vol. 57, no. 2, 2007, pp. 207-15.
Rhomberg PR, Jones RN. Contemporary activity of meropenem and comparator broad-spectrum agents: MYSTIC program report from the United States component (2005). Diagn Microbiol Infect Dis. 2007;57(2):207-15.
Rhomberg, P. R., & Jones, R. N. (2007). Contemporary activity of meropenem and comparator broad-spectrum agents: MYSTIC program report from the United States component (2005). Diagnostic Microbiology and Infectious Disease, 57(2), 207-15.
Rhomberg PR, Jones RN. Contemporary Activity of Meropenem and Comparator Broad-spectrum Agents: MYSTIC Program Report From the United States Component (2005). Diagn Microbiol Infect Dis. 2007;57(2):207-15. PubMed PMID: 16949243.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contemporary activity of meropenem and comparator broad-spectrum agents: MYSTIC program report from the United States component (2005). AU - Rhomberg,Paul R, AU - Jones,Ronald N, Y1 - 2006/09/01/ PY - 2006/05/14/received PY - 2006/07/14/accepted PY - 2006/9/5/pubmed PY - 2007/6/22/medline PY - 2006/9/5/entrez SP - 207 EP - 15 JF - Diagnostic microbiology and infectious disease JO - Diagn. Microbiol. Infect. Dis. VL - 57 IS - 2 N2 - The Meropenem Yearly Susceptibility Test Information Collection Program is a 9-year-old antimicrobial resistance surveillance network of more than 100 medical centers worldwide, including 15 sites in the United States (US) that monitors the susceptibility of Gram-negative and Gram-positive bacterial pathogens especially to carbapenems. In 2005, the antimicrobial activity of 11 broad-spectrum agents was assessed against 2910 bacterial isolates (2493 Gram-negative and 417 staphylococci) submitted from the US medical centers to a reference laboratory using Clinical and Laboratory Standards Institute susceptibility testing methods and interpretative criteria. Meropenem continued to demonstrate 1) high potency with MIC(90) values 4- to 16-fold lower than imipenem against the Enterobacteriaceae, 2) equal activity against Pseudomonas aeruginosa, 3) 2-fold less activity compared with imipenem against Acinetobacter spp., and 4) 4- to 8-fold less activity compared with imipenem against the oxacillin-susceptible staphylococci. The wide spectrum of activity for carbapenems against Enterobacteriaceae (1657 strains) was confirmed by the overall rank order by percentage susceptibility at breakpoint criteria: imipenem (98.9%) > meropenem (98.7%) > cefepime (97.6%) > piperacillin/tazobactam (92.0%) > ceftriaxone (91.2%) > aztreonam (90.6%) > gentamicin = tobramycin (90.5%) > ceftazidime (90.4%) > levofloxacin (84.9%) > ciprofloxacin (83.9%). Against Acinetobacter spp. isolates, only tobramycin (92.0% susceptible) and carbapenems (92.0-85.6%) exhibited acceptable levels of activity. A continued increase in the resistance rate for both ciprofloxacin and levofloxacin was observed with highest rates found among indole-positive Proteae species (36.5-33.3%) and Escherichia coli (21.6-20.4%) isolates, some documented by molecular typing methods as clonally related. Ongoing surveillance of meropenem and other broad-spectrum antimicrobial agents appears warranted to monitor the potency and spectrum of activity against indicated Gram-negative and-positive pathogens causing serious infections in the hospital setting, and to detect the emergence of new or novel resistance mechanisms that could compromise clinical utility (serine and metallo-carbapenemases). SN - 0732-8893 UR - https://www.unboundmedicine.com/medline/citation/16949243/Contemporary_activity_of_meropenem_and_comparator_broad_spectrum_agents:_MYSTIC_program_report_from_the_United_States_component__2005__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0732-8893(06)00283-5 DB - PRIME DP - Unbound Medicine ER -