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Relationships between patient- and institution-specific variables and decreased antimicrobial susceptibility of

Sujata M Bhavnani1, Jeffrey P Hammel, Alan Forrest

  • 1Cognigen Corporation, Buffalo, NY 14221-5831, USA. sujata.bhavnani@cognigencorp.com

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 29, 2003
PubMed

Insights

Identifying patients with antibiotic-resistant bacteria for clinical trials is challenging. Hospital stay duration, size, diagnosis, and service impact bacterial susceptibility to common antibiotics.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Pharmaceutical Research

Background:

  • Antibiotic resistance poses a significant threat to public health.
  • Clinical trials for new antimicrobial agents require precise patient selection.
  • Identifying factors influencing bacterial susceptibility is crucial for trial design.

Purpose of the Study:

  • To identify patient- and institution-specific factors associated with reduced bacterial susceptibility.
  • To analyze Enterobacter species, Pseudomonas aeruginosa, and Klebsiella pneumoniae resistance patterns.
  • To inform the design of clinical trials for antibiotic-resistant infections.

Main Methods:

  • Analysis of 5 years (1997-2001) of North American surveillance data.
  • Multivariable general linear modeling to assess relationships between MIC values and variables.
  • Evaluation of susceptibility to cefepime, ciprofloxacin, and piperacillin-tazobactam.

Main Results:

  • Hospital stay duration before pathogen isolation was a key factor.
  • Hospital size, primary diagnosis, and medical service also correlated with reduced susceptibility.
  • Combinations of these factors led to 16-32-fold increases in observed MIC90 values.

Conclusions:

  • Patient and institution-specific variables significantly influence bacterial susceptibility to antibiotics.
  • These findings are critical for optimizing patient selection in clinical trials.
  • Consideration of these factors can improve the efficiency of developing new anti-infective agents.

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