TARGET Surveillance, a part of the LIBRA initiative: the comparative activity of ciprofloxacin against urinary tract pathogens isolated during 2003
Abstract number: 1134_04_125
Morrissey I., Dowling K., Colclough A., McKeon M., Viljoen L., Veltman T.
To assess the prevalence of species and antibiotic (ABX) susceptibility of pathogens causing outpatient (out) & inpatient (in) urinary tract infections (UTIs) worldwide.
41 centres in 7 countries submitted 6203 isolates (2518 in and 3677 out): France (6 centres, 922 isolates), Germany (5, 707), Italy (12, 1051), Mexico (3, 143), South Africa (2, 146), Spain (3, 502) & USA (20, 2732). These were re-identified & MICs for common oral and parenteral ABX were determined using NCCLS broth microdilution assays.
The most common species associated with UTIs (where N > 100) was Escherichia coli (3743 isolates, 60.3%), followed by Klebsiella pneumoniae (508, 8.2%), Proteus mirabilis (400, 6.4%), Enterococcus faecalis (395, 6.4%), Pseudomonas aeruginosa (250, 4.0%), Enterobacter cloacae (144, 2.3%) & Klebsiella oxytoca (104, 1.7%). Generally lower antibacterial susceptibility was found with inpatients compared with outpatients. Lower susceptibility was also found to many AMs in Mexico, South Africa & Italy compared with other countries. The most significant difference was overall TSX susceptibility that reduced to 29.4% & 34.9% in Mexico & South Africa respectively. Susceptibilities (in vs out) for orally available ABX were: ciprofloxacin (CIP, 79.8% vs 85.6%), ampicillin (43.9% vs 50.0%), amoxycillinclavulanate (59.0% vs 65.4%), nitrofurantoin (72.4% vs 78.6%), & trimethoprim/sulphamethoxazole (TMP/SMX, 65.1% vs 68.8%). Susceptibilities for parenteral administration only ABX were: piperacillin/tazobactam (82.2% vs 85.4%), gentamicin (82.8% vs 86.8%), ceftriaxone (80.1% vs 88.1%), ceftazidime (84.6% vs 88.4%) & imipenem (89.6% vs 91.9%).
CIP was the most active orally available ABX against the total population of pathogens associated with UTIs from 7 countries worldwide. CIP also showed good activity compared to parenteral only ABX. This is important because CIP is available in parenteral as well as oral formulation, thus avoiding any oral-switch concerns that may be associated with parenteral only antibacterial agents.
|Session name:||XXIst ISTH Congress|
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