Thought this might interest some of you.
ANTIBIOTIC RESISTANCE TRENDS - EUROPE
A ProMED-mail post
Date: Thu, 04 Feb 1999 09:21:48 -0800
From: James Chin, CDPC-mail
Source: Eurosurveillance Weekly, 4 Feb 1999
Antimicrobial resistance surveillance
The second report of the Danish Antimicrobial Resistance Monitoring
and Research Programme (DANMAP) on human and animal antibiotic
consumption, and antibiotic resistance in bacteria from humans,
animals, and foodstuffs was recently summarised in EPI-NEWS. DANMAP
has been running for three years and was set up at the request of the
Danish ministers of Agriculture and Fisheries, and Health in 1995.
Antibiotic consumption in the primary care sector declined from 12.8
defined daily doses (DDD) per 1000 population in 1994 to 11.3 DDD/1000
in 1997. Consumption of the broad spectrum quinolones and
cephalosporins fell by 39% and 13%, respectively, from 1994 to 1997,
but rose by 2.9% and 9.5%, respectively, in the first nine months of
1998. Distribution of the use of different types of antibiotics has
helped to avoid resistance problems.
Antibiotic use in animals, for treatment or as a growth promoter, rose
Only one enterococcal isolate was shown to have acquired vancomycin
resistance. Resistance levels in _Escherichia coli_ were generally low
and no differences were found between strains isolated from people
with different occupations. Thirty-one per cent were resistant to
sulphonamide, 19% to ampicillin, and less than 1% to gentamicin or
quinolones. Four indicator bacteria are used: _Enterococcus faecium_,
_E. faecalia_, coagulase-negative staphylococci, and _E. coli_.
Isolates are collected from army recruits, nurses, slaughterhouse
workers, and pig farmers.
A similar scheme was set up in Scotland at the end of 1998. The pilot
system for the Surveillance of Antibiotic Resistance in Scotland
(SARS) had received one or more weeks' data from 13 of the 24
participating laboratories by 8 January 1999.
Large numbers of 4-quinolone resistant Enterobacteriaceae were
reported and reports of isolates of resistant enterococci and expanded
spectrum beta lactamase producing Enterobacteriaceae were higher than
Reported by Caroline Akehurst, PHLS Communicable Disease Surveillance
Centre, London, England and Ahilya Noone, Scottish Centre for
Infection and Environmental Health, Glasgow, Scotland
Date: Monday, February 01, 1999 1:34 PM
Source: JAMA 1999;281:67-71 & news media
Antibiotic resistance common in bacilli infecting European ICU
A multinational team reports high rates of antibiotic resistance among
aerobic gram-negative bacilli isolated from intensive care patients in
Dr. Hakan Hanberger and colleagues performed antibiotic susceptibility
tests on gram-negative bacilli isolated from intensive care patients
in Belgium, France, Portugal, Spain and Sweden. The researchers tested
9166 gram-negative strains collected from 7308 patients between June
1994 and June 1995.
Isolates from Portuguese ICUs had the highest percentage of decreased
antibiotic susceptibility "...across all species and drugs," while
isolates from Swedish ICUs had the lowest, Dr. Hanberger and his team
Isolates of _Pseudomonas aeruginosa_, Enterobacter species,
Acinetobacter species and _Stenotrophomonas maltophilia_ were most
highly resistant in all countries.
Amikacin and imipenem were the most effective of all the agents
"The high levels of decreased susceptibility among most species of
gram-negative bacilli to ceftazidime, ceftriaxone, piperacillin,
piperacillin-tazobactam, gentamicin, and ciprofloxacin in Belgium,
Portugal, France, and Spain further limits use of these drugs for
empirical monotherapy," Dr. Hanberger and his team say.
Infection control measures can limit the spread of multiresistant
bacteria, Dr. Hanberger and his team stress in the 6 Jan 1999 issue of
The Journal of the American Medical Association. Hospitals also should
adopt "...an active program for online antibiotic resistance
surveillance of common drugs...to constantly evaluate antibiotic
administration and pharmacy formulary options," they say. "These
measures have the potential to minimize morbidity and mortality
associated with infections caused by multiresistant bacteria in
critically ill patients."
Michele Gale-Sinex, communications manager
Center for Integrated Ag Systems
UW-Madison College of Ag and Life Sciences
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