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Incidence and susceptibility of aerobic Gram-negative bacilli from 20 Canadian intensive care units: 1989-1993
E A Bryce1, W D Colby, J Haket
1Division of Medical Microbiology, Department of Pathology, Vancouver Hospital, Vancouver, British Columbia; Division of Microbiology, University Hospital and University of Western Ontario, London, Ontario; Merck Frosst Canada Inc, Kirkland, Quebec; and Department of Microbiology and Infectious Disease, Hôtel-Dieu, Montreal, Quebec.
Objective:
To assess the prevalence of antibiotic resistance in Canadian intensive care units.
Design:
The antimicrobial profiles of 1939 Gram-negative bacilli isolated in 20 Canadian intensive care units were analyzed using a custom designed MicroScan panel.
Setting:
The majority of the hospitals were tertiary care institutions, but some community hospitals were included.
Patients:
Adult intensive care unit patients were the sources of isolates.
Main Results:
Pseudomonas aeruginosa was the most frequently isolated microorganism overall, with Escherichia coli the most common initial isolate. Comparison of initial and repeat isolates showed that P aeruginosa readily acquired resistance to all antibiotic classes except the aminoglycosides. Enterobacter aerogenes developed resistance to ciprofloxacin and Enterobacter cloacae demonstrated resistance to all beta-lactam antibiotics except for imipenem on repeat isolation. Other Enterobacteriaceae remained susceptible. Historical comparison with data derived four years previously from 15 of the centres showed increased resistance of P aeruginosa and Acinetobacter species to ciprofloxacin while other susceptibility patterns remained stable.
Conclusions:
The prevalence of Gram-negative resistance in Canadian hospitals is less than that reported in surveys done in some other countries, and was relatively stable over four years.
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