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PubMedDate not supplied

In vitro antibacterial activity of men 10700, a new penem antibiotic.

We report here the antibacterial activity of the new penem antibiotic Men 10700 against a total of 740 gram-positive and gram-negative clinical isolates, in comparison to imipenem, meropenem, cefotaxime, ceftriaxone, ciprofloxacin and gentamicin. Men 10700 has shown a wide spectrum of antibacterial activity, with a potent activity both against gram-positive species (with the exception of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis) as indicated by minimal inhibitory concentration (MIC(90)) values < or =0.5 mg/l, and gram-negative species, with MIC(90) values generally < or =2 mg/l. Men 10700 was the most potent antibiotic against methicillin-susceptible S. aureus and S. epidermidis, while the overall spectrum of activity resembled that of imipenem; meropenem was more active against most gram-negative species. In comparison with third-generation cephalosporins, Men 10700 demonstrated superior activity against methicillin-susceptible S. aureus and S. epidermidis and some gram-negative species such as Morganella morganii, Serratia spp. and Enterobacter cloacae; moreover, in contrast to third-generation cephalosporins, Men 10700 showed moderate activity against Enterococcus spp. The activity of Men 10700 against penicillin-resistant Streptococcus pneumoniae (10 strains) and some gram-negative strains selected for their resistance to cefotaxime (20 strains) was particularly interesting.

Anti-Bacterial Agents↗

PubMedDate not supplied

Comparative in vitro activity of S-4661, a new parenteral carbapenem, and other antimicrobial agents against respiratory pathogens.

The activity of S-4661, a new parenteral carbapenem antibiotic, was evaluated against 202 recent clinical isolates of respiratory pathogens. S-4661 was similar to or 2 times more active than imipenem, meropenem, and biapenem, and 8-128 times more active than ceftazidime against gram-positive bacteria. Against gram-negative bacteria, S-4661 was slightly less active than meropenem, but 2-8 times more active than the other agents. In particular, against Pseudomonas aeruginosa S-4661 showed the most potent activity. Thus it was found that S-4661 possesses a potent and well-balanced activity against respiratory pathogens.

Anti-Bacterial Agents↗

PubMedDate not supplied

In vitro susceptibility of Listeria monocytogenes: comparison of the E test with the agar dilution test.

In vitro susceptibility testing was performed on 66 strains of Listeria monocytogenes. Recently obtained clinical isolates from Austria, France, Norway and Switzerland and 17 reference strains from three type culture collections were tested against ampicillin, gentamicin, trimethoprim-sulfamethoxazole, ampicillin-sulbactam, meropenem, and first-, second-, third- and fourth-generation cephalosporins. All isolates were susceptible to ampicillin, gentamicin, and trimethoprim-sulfamethoxazole, ampicillin-sulbactam, and meropenem and more than 86% of the minimal inhibitory concentration E test values were within plus/minus one dilution step of the agar dilution test. In vitro susceptibility of L. monocytogenes has not changed markedly during the last decades; the level of susceptibility of old reference strains did not differ from that of recently encountered clinical isolates. The E test seems to be a suitable method for Listeria.

Anti-Bacterial Agents↗

PubMedDate not supplied

Prevalence and in-vitro antimicrobial susceptibility patterns of Acinetobacter strains isolated from patients in intensive care units.

Fifty-six Acinetobacter species strains (49 Acinetobacter baumanii, 5 Acinetobacter calcoaceticus, 2 Acinetobacter iwoffii) were detected using both conventional methods and gas chromatography of bacterial fatty acids with the MIDI Sherlock Microbial Identification System. The susceptibilities of these strains to 16 antimicrobial agents were investigated by the disc-diffusion method according to the National Committee for Clinical Laboratory Standards. The production of extended-spectrum beta-lactamases (ESBLs) and inducible beta-lactamases (IBLs) by the strains were investigated by the double-disc-synergy and disc-approximation methods, respectively. Imipenem was the most effective agent for Acinetobacter baumanii strains (95.9% of strains were sensitive), while meropenem and netilmicin showed moderate activity (87.7% and 79.6% of strains, respectively, responded). Acinetobacter baumanii strains were less sensitive to cefoperazone-sulbactam (53.1%), ofloxacin (51.0%), ciprofloxacin (42.8%), and amikacin (36.7%). Acinetobacter calcoaceticus and Acinetobacter iwoffii strains were sensitive to imipenem, meropenem and netilmicin. IBLs and ESBLs were produced, respectively, by 8.9% and 7.1% of all bacterial strains. The strains isolated were sufficiently sensitive to imipenem, but not to ofloxacin or ciprofloxacin, and were very resistant to amikacin.

Acinetobacter↗

PubMedDate not supplied

Comparative in vitro activity of isepamicin and other antibiotics against gram-negative bacilli from intensive care units (ICU) in Belgium.

The in vitro activity of isepamicin was compared to that of amikacin, gentamicin, cefepime, ciprofloxacin and meropenem against Gram-negative bacilli isolated from patients hospitalized in the intensive care unit (ICU) of 11 Belgian university or general hospitals between November 1998 and July 1999. The minimal inhibitory concentrations (MIC) for 1087 non-duplicate, consecutive aerobic Gram-negative isolates, including 798 Enterobacteriaceae and 289 non-fermenters, were determined by E-test for each antibiotic. Overall, isepamicin was active against 91% of all isolates and was found more active than ciprofloxacin (84% susceptibility), gentamicin (88% susceptibility), cefepime and amikacin (89% susceptibility each), but less active than meropenem (94% susceptibility). Enterobacter aerogenes isolates exhibited the highest resistance rate to ciprofloxacin (72%) while P. aeruginosa appeared the most resistant (frequently multi-resistant) pathogen. Compared to amikacin, MIC values for isepamicin were usually two- to fourfold lower for most inducible Enterobacteriacieae species and for Klebsiella spp., while they were identical for P. aeruginosa and other non-fermenters. Complete cross-susceptibility or cross-resistance between amikacin and isepamicin was observed in more than 95% of all tested isolates. On the other hand, 12% of all E. aerogenes isolates appeared resistant to amikacin and susceptible to isepamicin, while 6% of the P. aeruginosa were found to be resistant (or intermediate) to isepamicin and intermediate (or susceptible) to amikacin. No significant differences in pathogen distribution nor in resistance rates were observed between hospitals except for P. aeruginosa. Taking into account the species distribution and the prevalence of resistance to the different antibiotics tested, isepamicin appears as a suitable agent for empiric therapeutic use in severe ICU-acquired Gram-negative infections in Belgium.

Anti-Bacterial Agents↗

PubMed1999

Susceptibility of 497 clinical isolates of gram-negative anaerobes to trovafloxacin and eight other antibiotics.

Trovafloxacin is a novel investigational trifluoronaphthyridone antibiotic with broad-spectrum activity against Gram-positive and Gram-negative organisms. Its in-vitro activity and those of eight other antimicrobial agents were evaluated against 497 clinical isolates of Gram-negative anaerobic bacteria by the agar dilution method. Trovafloxacin had excellent activity, with a minimum inhibitory concentration (MIC) range of <0.03-4 microg/ml, against all species. Out of the 497 isolates tested, 496 (99.5%) were inhibited by a concentration of < or = 2.0 microg/ml of trovafloxacin; the remaining two strains were inhibited by a concentration of 4.0 microg/ml. The MIC50s and MIC90s were 0.12 microg/ml and 1.0 microg/ml, respectively. Meropenem, imipenem and piperacillin/tazobactam were also very active. Overall, at the MIC90s, trovafloxacin was as active as meropenem, slightly more active than metronidazole and imipenem, twice as active as amoxicillin-clavulanic acid, five times more active than piperacillintazobactam and 68 times more active than clindamycin. About 21% of the isolates were resistant to cefoxitin, 30% to clindamycin and 40% to piperacillin. Five species in the Bacteroides fragilis group of isolates were highly resistant to metronidazole (MIC >128 microg/ml). In general, the relatively more resistant species were the B. vulgatus, B. ovatus, B. thetaiotaomicron, and B. fragilis sensu stricto, in that order. All the isolates of the B. fragilis group and about 50% of the Prevotella spp. were beta-lactamase positive. Trovafloxacin certainly holds promise as an alternative drug for therapy of anaerobic infections.

Anti-Bacterial Agents↗

PubMed2001

Influence of in-vivo endotoxin liberation on anti-anaerobic antimicrobial efficacy.

The ability of cefoxitin, clindamycin, imipenem, meropenem, metronidazole and piperacillin-tazobactam to cause gram-negative anaerobic bacteria to release endotoxin and the influence of such liberated endotoxin on antibiotic efficacy were investigated in in-vivo experiments in animal models. Experimental infections in various animal models (mice, hamster and infant rats) with cultures of wild and reference strains of Bacteroides fragilis group and Fusobacterium spp. were carried out by injecting these animals with different inocula (10(6), 10(7) and 10(8) cfu/ml) of the bacterial suspension, Appropriate doses of the test antibiotics were then injected and the plasma lipopolysaccharide (endotoxin) release measured by the Limulus Amoebocyte Lysate (LAL) Assay. Evidence of worsening of the outcome of the infections post-therapy was assessed, including histopathological changes in the internal organs. Infection with generalized septicemia was established with F. nucleatum in the mice and hamster models while with the B. fragilis group, infections only led to intra-abdominal abscess formation. Plasma endotoxin release was higher in animals infected with F. nucleatum than B. fragilis and was unrelated to the bacterial inoculum. Imipenem, meropenem and cefoxitin, in that order, induced the highest levels of endotoxin activities in the animal model, particularly following F. nucleatum infection. Histological examination of the internal organs of various animals showed variation in the pattern of histopathological changes; grades 3-4 inflammatory changes in the liver were observed in the Fusobacterium-infected animals that were treated with the carbapenems and cefoxitin. Therapy with the other antibiotics did not exacerbate anaerobic sepsis. In this study, bacteremia did not lead to massive endotoxin release and antibiotic therapy appeared not to have negatively influenced the outcome of most of the gram-negative anaerobic infections, except for infections caused by Fusobacterium spp. However, it is conceivable that if the gastrointestinal tract is the source of the endotoxin in patients with systemic inflammatory response syndrome, then the obligate anaerobes like Bacteroides and Fusobacterium species, which are members of the gut flora, may play a major role in the unfavorable outcome of antibiotic therapy in some of these infections.

Animals↗

PubMed2001

De-escalation antimicrobial chemotherapy in critically III patients: pros and cons.

In spite of advances in critical care, nosocomial infections still have a considerable impact on Intensive Care Unit (ICU) and hospital length of stay, mortality and costs. Several authors suggest that antibiotic therapy should be instituted as soon as sepsis is suspected in critically patients. Over the last two decades the rates of occurrence for pathogens have significantly changed under selective pressure from broad-spectrum antimicrobial therapy. Shifts from predominance of gram-negative to gram-positive organisms and outbreaks of resistant pathogens address the need for appropriate empirical regimens. Agents such as ceftazidime, imipenem and, more recently, meropenem and tazobactam have been used successfully as monotherapy. Two different clinical trials have reported that meropenem monotherapy is significantly more effective than ceftazidime-based therapy. Because of the outbreak of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis, some investigators suggest adding a glycopeptide to beta-lactamase inhibitor and carbapenem as initial empirical therapy. Such a regimen should be administered before definitive proof of infections and until the results of microbial investigation are available (de-escalation antimicrobial chemotherapy). On the other hand, several authors do not recommend glycopeptide administration in an attempt to limit nosocomial outbreaks of vancomycin-resistant enterococci (VRE) and staphylococci (VRS) and to avoid secondary drawbacks, such as nephrotoxicity and ototoxicity. De-escalation antimicrobial chemotherapy should be tailored to critically ill patients according to their clinical status, severity of illness and suspicion of sepsis or nosocomial pneumonia.

Anti-Bacterial Agents↗

PubMed2005

In vitro evaluation of faropenem activity against anaerobic bacteria.

Faropenem, a new oral penem with broad spectrum activity, could be used as empirical treatment in infections due to unidentified anaerobes, but only a few investigations have been carried out on these bacteria. The aim of this study was to compare faropenem in vitro activity with that of positive antimicrobial controls (metronidazole, imipenem, meropenem, amoxicillin, amoxicillin-clavulanic acid, ticarcillin-clavulanic acid, cefotetan, cefoxitin and clindamycin) against 462 anaerobic bacterial strains. The reference agar dilution method was used according to the NCCLS standard. Faropenem demonstrated high antimicrobial activity, similar to that of both imipenem and meropenem (faropenem Minimal Inhibitory Concentrations 50% and 90% were 0.12 and 1 mg/L for all Gram-negative anaerobes, 0.25 and 1 mg/L for all Gram-positive anaerobes). Only 5 strains of the Bacteroides fragilis group (1.1% of all anaerobes) were resistant to faropenem, which compared favorably with that of other reference antianaerobic drugs. The results obtained confirm those previously reported.

Anti-Bacterial Agents↗

PubMed2006

Impact of carbapenem administration on systemic endotoxemia in patients with severe sepsis and Gram-negative bacteremia.

In order to investigate the effect of carbapenems on systemic endotoxemia, 20 patients with severe sepsis due to ventilator-associated pneumonia and Gram-negative bacteremia were enrolled; 10 (group A) were administered 1 g t.i.d. of imipenem/cilastatin and 10 (group B) 2 g t.i.d. of meropenem. Blood was sampled at 0 time and after 1, 2, 4, 6, 12, 24, 36, 48, 60, 72, 84 and 96 hours for detection of endotoxins (LPS), interleukin-6 (IL-6), C-reactive protein (CRP) and drug levels. LPS were determined by the QCL-1000 LAL assay, IL-6 by an enzymeimmunoassay, CRP by nephelometry and carbapenem levels by a microbiological assay. We did not find that carbapenems had any effect on the kinetics of LPS and CRP; IL-6 of group A was lower than group B at 72 and 84 hours. No correlation was observed between drug levels of any carbapenem and LPS, IL-6 or CRP. It is concluded that in septic patients with Gram-negative bacteremia administration of either imipenem or meropenem did not affect systemic endotoxemia. The above data support the safe administration of both carbapenems in patients with severe sepsis.

Aged↗

PubMed1995

Adverse effects of monobactams and carbapenems.

Monobactams and carbapenems are 2 classes of beta-lactam antibiotics that were introduced in the 1980s. This review considers the monobactam aztreonam and the carbapenems imipenem and meropenem. Imipenem is administered together with cilastatin, which inhibits the enzymatic breakdown of imipenem in the kidney. The antibacterial activities of these drugs are quite different from older beta-lactams. Aztreonam is directed towards aerobic Gram-negative bacteria, especially Pseudomonas aeruginosa, while imipenem and meropenem are active against both aerobic and anaerobic Gram-positive and Gram-negative bacteria. Thus, these drugs should be reserved for patients who have a special need for them. They are also structurally different from older beta-lactams and possess different adverse drug reaction profiles. It was initially suggested that aztreonam would be less immunogenic than previous beta-lactams because reactive breakdown products acting as haptens are less likely to be formed. Clinical reports now support this assumption, and, in particular, cross hypersensitivity between aztreonam and other beta-lactams seems to be rare which makes the drug a useful therapeutic alternative. However, hypersensitivity to aztreonam does occur. The predominant concern in terms of adverse reactions to imipenem/cilastatin is the increased tendency to cause seizures compared with other beta-lactams. The risk of producing a seizure is highly associated with inadequate dose adjustment in relation to kidney function. If appropriate care is taken, seizures occur in less than 1% of patients treated. However, it is possible that concomitant administration of other drugs with neurotoxic profiles (e.g. theophylline and cyclosporin) given in overdose, may increase the risk of seizures.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2000

Comparative pharmacokinetics of the carbapenems: clinical implications.

During the last few decades, several carbapenems have been developed. The major characteristic of the newer drugs, such as MK-826, is a prolonged half-life. Alternatively, some carbapenems have been developed that can be given orally, such as CS-834 and L-084. Although imipenem and panipenem have to be administered with a co-drug to prevent degradation by the enzyme dehydropeptidase-1 and reduce nephrotoxicity, the newer drugs such as meropenem, biapenem and lenapenem are relatively stable towards that enzyme. Structural modifications have, besides changes in pharmacology, also led to varying antimicrobial properties. For instance, meropenem is relatively more active against Gram-negative organisms than most other carbapenems, but is slightly less active against Gram-positive organisms. Except for half-life and bioavailability, the pharmacokinetic properties of the carbapenems are relatively similar. Distribution is mainly in extracellular body-water, as observed both from the volumes of distribution and from blister studies. Some carbapenems have a better penetration in cerebrospinal fluid than others. In patients with renal dysfunction, doses have to be adjusted, and special care must be taken with imipenem/cilastatin and panipenem/betamipron to prevent accumulation of the co-drugs, as the pharmacokinetic properties of the co-drugs differ from those of the drugs themselves. However, toxicity of the co-drugs has not been shown. The carbapenems differ in proconvulsive activity. Imipenem shows relatively the highest proconvulsive activity, especially at higher concentrations. Pharmacodynamic studies have shown that the major surrogate parameter for antimicrobial efficacy is the percentage of time of the dosage interval above the minimum inhibitory concentration (MIC). The minimum percentage percentage of time above the MIC (TaM) needed for optimal effect is known in animals (30 to 50%), but not in humans. It is probably less than 100%, but may be higher than 50%. Dosage regimens currently in use result in a TaM of about 50% at 4 mg/L, which is the current 'susceptible' breakpoint determined by the National Committee for Clinical Laboratory Standards (NCCLS) for most micro-organisms. Dosage regimens in patients with reduced renal clearance should be based on the TaM. The increased half-life of the newer carbapenems will probably lead to less frequent administration, although continuous infusion may still be the optimal mode of administration for these drugs. The availability of oral carbapenems will have a profound effect on the use of carbapenems in the community.

Carbapenems↗

PubMed2003

Doripenem: S 4661.

Doripenem [S 4661] is a new parenteral carbapenem antibacterial undergoing clinical trials in Japan and North America. It is characterised by a 1beta-methyl group and a sulfamoylaminomethyl substituted pyrrolidylthio group at the C2 position. The compound has good activity against both Gram-positive and Gram-negative bacteria and superior activity to meropenem and imipenem against Pseudomonas aeruginosa. It possesses higher stability than imipenem or meropenem against animal dehydropeptidase I. The compound is stable to most beta-lactamases produced by Gram-negative bacteria. Shionogi has stated that doripenem is expected to be effective at low doses. In May 2003, Shionogi and Peninsula Pharmaceuticals (USA) entered a licensing agreement for doripenem under which Peninsula obtained exclusive rights (including sublicense rights) to market and develop the product in North America. Shionogi will manufacture doripenem for worldwide distribution. Doripenem is currently undergoing phase III trials in Japan for pneumonia, chronic respiratory tract infections (RTIs) and urinary tract infections (UTIs). In its November 2002 pipeline, Shionogi stated that it plans to file a NDA in Q4 of 2003. Doripenem is also in phase II studies in hospitalised patients with complicated urinary tract infections including pyelonephritis. In September 2003, Peninsula announced it had completed enrolment in this trial, and results are expected later in the year. Doripenem has also completed two phase I studies in healthy volunteers with a number of different dosing regimens.

Anti-Bacterial Agents↗

PubMed1997

Affinities of BO-2727 for bacterial penicillin-binding proteins and morphological change of gram-negative rods.

Affinities of BO-2727, a new carbapenem, for penicillin-binding proteins (PBPs) of Escherichia coli. Pseudomonas aeruginosa and Staphylococcus aureus were studied. BO-2727 showed preferential affinity for PBP-2 of E. coli. and induced swollen and ovoid cells, when the organism was exposed to the MIC. In contrast, BO-2727 bound to both PBPs-2 and -3 of P. aeruginosa to a similar extent, and induced short filament cells with bulge. As compared with imipenem and meropenem, there was an observed difference in the affinity, especially for PBP-3, in both organisms; BO-2727 displayed intermediate affinity for PBP-3 between meropenem and imipenem. Studies on the affinity for PBPs of methicillin-susceptible S. aureus showed that the IC50 values for PBP-1 was roughly correlated with the MIC values of carbapenems tested, but those for the PBPs-2 and -3 appeared to be greater than the MIC values. In further studies on the affinity for PBP-2' of methicillin-resistant S. aureus. BO-2727 displayed better binding kinetics than imipenem, which reflected the better activity of BO-2727 than that of imipenem.

Bacterial Proteins↗

PubMed2006

Bacteriological agents of neonatal sepsis in NICU at Nishtar Hospital Multan.

OBJECTIVE: To find clinical features and bacteriological agents of neonatal sepsis and to determine their antibiotic sensitivity pattern. DESIGN: An observational study. PLACE AND DURATION OF STUDY: Paediatric Medicine Unit II, Nishtar Hospital, Multan, from July 2003 to January 2004. PATIENTS AND METHODS: Neonates admitted with, or clinically suspected to develop neonatal sepsis during their hospital stay, for another reason, were included in this study. Common clinical features were noted and blood culture reports were analyzed for etiological microorganisms and their antibiotic sensitivity pattern. RESULTS: Among the total 115 cases of clinically suspected neonatal sepsis, 62 (54%) had culture proven sepsis. Out of these 26(42%) presented as early onset sepsis and 36(58%) as late-onset sepsis. Among the bacteriological isolates, gram negative organisms (58%) were slightly more common in both early-onset and late-onset sepsis. Among the Gram-negative isolates E.coli (37%) was the commonest organism followed by Klebsiella (9.6%). Among the gram +ve organisms Staphylococcus aureus (32%) was most frequent. All the microorganisms were resistant to ampicillin. E.coli were mostly sensitive to ceftriaxone(75%), ceftazidime (78%), meropenem (88%), imipenem (80%), and ciprofloxacin (52%). Staphylococcus aureus were more sensitive to ciprofloxacin (85%), meropenem (87%), imipenem (82%) as compared to cephalosporins and aminoglycosides. CONCLUSION: E.coli and Staph. aureus are the most common organisms causing neonatal sepsis and there is high degree of resistance to commonly used first line antibiotics.

Age Factors↗

PubMedDate not supplied

Neutralization of beta-lactam antibiotics in an environmental monitoring medium.

The neutralizing ability of Difco Bacto Penase, BBL Penicillinase, and Genzyme beta-lactamase for penicillin G, oxacillin, cephalothin, cefazolin, ceftazidime, ceftriaxone, cefotaxime, imipenem, and meropenem was determined in an agar medium. Trypticase soy agar plates (20 mL) containing 200 MU/L Difco Penase, 200 MU/L BBL Penicillinase, or 2 vials/L of Genzyme beta-lactamase were dosed with 20, 50, and 100 micrograms of each antibiotic and then inoculated (50-100 CFU/plate) with a susceptible microorganism. Percentage recoveries of the organism were calculated after incubation. Genzyme beta-lactamase effectively neutralized 100 micrograms of all the antibiotics except ceftazidime (32% recovery with 20 micrograms). The two penicillinases effectively neutralized 100 micrograms of penicillin G, oxacillin, cephalothin, and cefazolin; were slightly effective against ceftriaxone and cefotaxime (20-57% recovery with 20 micrograms); and totally ineffective against ceftazidime, imipenem, and meropenem. This investigation resulted in a useful procedure for qualifying and/or selecting a beta-lactamase for use in environmental monitoring medium to neutralize a particular beta-lactam.

Anti-Bacterial Agents↗

PubMed1999

Susceptibility of anaerobic bacteria in Auckland: 1991-1996.

AIM: To determine the antimicrobial susceptibility of local anaerobic bacteria. METHOD: The antimicrobial susceptibility of 357 obligate anaerobes collected between 1991 and 1997 was determined by a standard agar dilution method. Isolates tested included Bacteroides spp. 131, Fusobacterium spp. 12, Prevotella spp. 13, Veillonella spp. 5, Clostridium perfringens 27, other Clostridium spp. 29, Propionibacterium spp. 57, Actinomyces spp. 7, other non-sporing gram-positive bacilli 28 and Peptostreptococcus spp. 48. Ten antimicrobials were tested: penicillin, amoxycillin/ clavulanic acid, pipercillin/tazobactam, ceftriaxone, cefoxitin, cefotetan, imipenem, meropenem, clindamycin and metronidazole. RESULTS: Imipenem, pipercillin/tazobactam, meropenem and amoxycillin/clavulanic acid were active against virtually all anaerobes tested. Metronidazole was active against all anaerobic gram-negative bacteria and Clostridium spp., but had variable activity against other anaerobes. Cefoxitin was the most active cephalosporin against Bacteroides spp., with 76%, 64% and 15% of Bacteroides spp. being susceptible to cefoxitin, cefotetan and ceftriaxone, respectively. Penicillin had poor activity against anaerobic gram negative bacilli. Actinomyces and Propionibacterium spp. were susceptible to all antimicrobials tested except metronidazole. Variable results were obtained with other antimicrobial-organism combinations. Comparison of results with data from a previously published survey showed little change in susceptibility except for increased resistance of Bacteroides fragilis to ceftriaxone and Clostridium species (not C perfringens) to clindamycin. CONCLUSION: Our results update the local susceptibility profile of anaerobic bacteria and may be considered when choosing an antimicrobial agent for prophylaxis or treatment of anaerobic infections.

Anti-Bacterial Agents↗

PubMed2000

Detection of emerging resistance patterns within longitudinal surveillance systems: data sensitivity and microbial susceptibility.

Communicating information from antimicrobial resistance surveillance study data to microbiologists and physicians can be challenging. Large amounts of data, commonly reaching millions of MICs or zone 20diameter endpoints, must be analysed and condensed to easily-read tables or figures. Furthermore, data must not be prejudged relative to susceptibility categories, because of the diverse nature of interpretive criteria available internationally. An attempt must be made to present results of all surveillance studies in a mode that can be reinterpreted for immediate use in different geographical areas, or used to compare future data with relative ease and high accuracy. Such data displays require peer-reviewed journals to permit greater numbers of more complex tables to present results. The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) study is a year-on-year global surveillance programme in medical centres where meropenem is available for use. We have developed a presentation strategy that expands the long-term clinical value of MYSTIC results. In addition to statistical parameters, tables of cumulative percentages or numbers of strains inhibited at each tested antimicrobial concentration will be presented. Alternative figures (Finland-o-grams) could also be used, but these generally lack precise extractable rates and require more journal space. Regardless of study design, promotion of this presentation philosophy enhances any surveillance study's value to each reader or user and facilitates application to locally appropriate interpretations. The widespread use of these analysis and presentation principles as benchmarks by various resistance studies and networks is strongly encouraged, particularly by investigations across international boundaries.

Journal Article↗