Common bacteria whose susceptiblity to antimicrobials is no longer predictable

Department of Pathology, University of Louisville School of Medicine, KY 40202, USA.
Le Journal médical libanais. The Lebanese medical journal 01/2000; 48(4):208-14.
Source: PubMed


The widespread use of antibiotics has been responsible for the development of numerous problems including the emergence of multidrug resistant bacteria, increased number of nosocomial- and community-acquired infections, less than optimal patient outcome, and increased health care costs. Of equal concern is the emergence of resistance in clinical isolates to antibiotics that were once considered "standard" with predictable in vitro susceptibility patterns. Such resistance has been especially notable in organisms that are commonly encountered in a variety of infections including, Streptococcus pneumoniae, Staphylococcus aureus. Enterococci, Klebsiella pneumoniae, and Escherichia coli. It is important for the clinical microbiology laboratory to provide the practicing clinician with accurate and timely antimicrobial susceptibility information which requires the application of standardized and approved in vitro testing methods. The laboratory also serves as a sentinel by maintaining an active monitoring and surveillance program in which current in vitro susceptibility patterns can be compared with local, regional, and national data bases.

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    • "The widespread use of antibiotics has been responsible for the development of numerous problems including the emergence of multidrug resistant bacteria, increased number of nosocomial (hospital) and community-acquired infections; and increased health care costs (Snyder et al., 2000). Staphylococcus aureus is a pathogen of greater concern because of its virulence (Chambers, 2005), its ability to cause a diverse array of life threatening infections, and its capacity to adapt to different environmental conditions (Lowy, 1998; Lowy, 2003). "
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    ABSTRACT: Antimicrobial resistance has become a great public health problem worldwide and multi-drug resistance Staphylococcus aureus has been widely reported. This study determined the pattern of resistance to ten commonly used antibiotics. Urine samples collected from healthy women volunteers in the Abuja were cultured and screened for S. aureus using standard microbiological procedures. The antibiotic susceptibility of the isolates was investigated using disc diffusion technique. A total of 60 (40%) S. aureus isolates were isolated from 150 urine samples collected. Of these, 19 (32%), 22 (36%) and 19 (32%) were from married but not pregnant, pregnant and single women, respectively. The isolates were highly resistant to ampicillin (91.7%), clindamycin (78.3%), cephalexin (75%), methicillin (71.7%) and vancomycin (68.3%) but had very low resistance to gentamicin (3.3%), ciprofloxacin (3.3%), ofloxacin (3.3%), sparfloxacin (3.3%) and pefloxacin (10.0%). A total of 43 (71.7%) of the isolates showed multi-drug resistance and only 3 (5%) were susceptible to all the antibiotics tested. Multi-drug resistant S. aureus is highly prevalent in the urine of healthy women investigated in Federal Capital Territory. This calls for effective measures against irrational use of antibiotics.
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    ABSTRACT: Objective: To assess common clinically significant isolates and determine their antimicrobial susceptibility patterns. Design: A retrospective study for bacterial isolates from clinical sources including urine, pus, blood and cerebrospinal fluid. Bacterial susceptibility testing was done by the standardized disk agar diffu-sion technique. Setting: The study has utilized microbiology laboratory records in the governmental hospitals of Gaza Strip, Palestine (11 hospitals with 1376 beds) during four different months (January, April, July and October, 2003). Subjects: A total of 2844 isolates (924 Gram positive and 1920 Gram negative) were scrutinized. Results: The resistance of Staphylococcus aureus was 73.2% to amoxycillin and 1.8% to vancomycin. For Streptococcus pneumoniae, 40.4% was resistance to penicillin and 7.4% to erythromycin. Conclusions: The increasing resistance of organisms indicates that periodic monitoring and possibly modification of empirical therapy are required.
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