The Experts below are selected from a list of 26709 Experts worldwide ranked by ideXlab platform

Shaochun Chen - One of the best experts on this subject based on the ideXlab platform.

  • disk diffusion testing is an inappropriate screening tool for cephalosporin resistant gonorrhoea strains in clinical practice in china
    Infection and Drug Resistance, 2020
    Co-Authors: Yan Han, Yueping Yin, Xiaoyu Zhu, Shaochun Chen, Xiuqin Dai, Ligang Yang, Bangyong Zhu, Na Zhong, Wenling Cao, Xiaohui Zhang
    Abstract:

    Purpose Injectable Ceftriaxone and oral cefixime are the last agents effective against Neisseria gonorrhoeae. In vitro antimicrobial-susceptibility testing (AST) is done to identify the most efficacious antibiotic needed to combat the infection in that particular individual. The objective of this study was to evaluate whether Kirby-Bauer (KB) disk-diffusion tests can detect N. gonorrhoeae isolates that have decreased susceptibility to Ceftriaxone and cefixime for appropriate clinical management. Methods A total of 1,633 consecutive clinical isolates of N. gonorrhoeae were collected from January 1, 2013 to December 31, 2017 from seven dermatology clinics located in five provinces in China. Consistency between KB disk-diffusion tests and the agar-dilution method, as well as sensitivity of the KB test for detecting N. gonorrhoeae isolates with decreased susceptibility to Ceftriaxone and cefixime, were determined using 1,306 clinical isolates that had been recovered to complete agar-dilution AST. Results The prevalence of isolates with decreased susceptibility to Ceftriaxone and cefixime was 12.1% (198 of 1,633) and 12.7% (208 of 1,633), respectively, using KB disk-diffusion tests. The prevalence of isolates with decreased susceptibility was 9.9% (129 of 1,306) for Ceftriaxone and 9.9% (129 of 1,305) for cefixime using agar-dilution AST. The categorical agreement of these two methods was 80.9% for both Ceftriaxone and cefixime. Compared to agar-dilution AST, the sensitivity of the KB test for detecting N. gonorrhoeae isolates with decreased susceptibility was 22.5% (29 of 129) for Ceftriaxone and 29.5% (38 of 129) for cefixime, and its specificity 87.3% (1,028 of 1,177) for Ceftriaxone and 86.7% (1,018 of 1,176) for cefixime. Conclusion Although KB tests are easy to carry out in clinical practice, their ability to detect cephalosporin-resistant gonorrhoea strains is limited. This method is not an appropriate selection for screening cephalosporin-resistant gonorrhoea strains in clinical practice in China.

  • widespread use of high dose Ceftriaxone therapy for uncomplicated gonorrhea without reported Ceftriaxone treatment failure results from 5 years of multicenter surveillance data in china
    Clinical Infectious Diseases, 2020
    Co-Authors: Shaochun Chen, Ligang Yang, Na Zhong, Xiaohui Zhang, Zhizhou Wu, Liufeng Yuan, Zhongjie Zheng, Lishan Feng, Xiangsheng Chen
    Abstract:

    Background Antimicrobial resistance to Neisseria gonorrhoeae has emerged for each of the antibiotics recommended as first-line therapies following their introduction into clinical practice. To improve rational and effective clinical antibiotic treatment, we analyzed the prescription patterns of antibiotics and their therapeutic effect in the treatment of uncomplicated gonorrhea in China. Methods We obtained data from a follow-up multicenter surveillance program. Multinomial logistic regression analyses were conducted to explore the associations between demographic/clinical variables with the levels of sensitivity to Ceftriaxone and prescription of high-dose Ceftriaxone. Results In this study, 1686 patients infected with N. gonorrhoeae were recruited in a surveillance network during 1 January 2013 through 31 December 2017 in 7 hospitals distributed in 5 provinces. The prevalence of isolates with decreased susceptibility to Ceftriaxone was 9.8% (131/1333), fluctuating between 5.6% and 12.1%. Injectable Ceftriaxone was chosen as the first-line treatment among 83.1% of patients, and most of them (72.7% [1018/1401]) received >1000 mg dosage. Patients who were previously infected with gonorrhea or other sexually transmitted infections (adjusted odds ratio [AOR], 1.618 [95% confidence interval {CI}, 1.11-2.358]; AOR, 2.08 [95% CI, 1.41-3.069]) or who already used antibiotics for this infection (AOR, 1.599 [95% CI, 1.041-2.454]) were associated with a higher prescribed Ceftriaxone dosage. All of the patients recruited in this study were cured regardless of the isolates' susceptibility to Ceftriaxone or the dosage of Ceftriaxone they received. Conclusions No Ceftriaxone treatment failure for uncomplicated gonorrhea was reported in China; however, high-dose Ceftriaxone was widely used in China. Its impacts need further study.

  • p691 widespread use of high dose Ceftriaxone therapy for uncomplicated gonorrhea without reported Ceftriaxone treatment failure
    Sexually Transmitted Infections, 2019
    Co-Authors: Shaochun Chen, Xiangsheng Chen
    Abstract:

    Background Antimicrobial resistance (AMR) to N. gonorrhoeae has emerged for each of the antibiotics following their introduction into clinical practice recommended as first-line therapies. To improve rational and effective clinical antibiotic treatment, we analyzed the prescription patterns of antibiotics and its therapeutic effect in the treatment of uncomplicated gonorrhea in China. Methods We obtained data from a follow-up multicenter-surveillance program. Multinomial logistic regression analyses were conducted to explore the associations between demographic/clinical variables with the levels of sensitivity to Ceftriaxone and prescription of high-dose Ceftriaxone. Results In this study, 1686 patients infected with N. gonorrhoeae were recruited in a surveillance network during the period of 1 January 2013 through 31 December 2017 in 7 hospitals distributed in 5 provinces. The prevalence of isolates with decreased susceptibility to Ceftriaxone was 9.8% (131/1333), fluctuating between 5.6%∼12.1%. Injectable Ceftriaxone was chosen as the first-line treatment among 83.1% patients, and most of them (72.7%,1018/1401) received more than 1000 mg dosage. Patients who were infected with gonorrhea or infected with other STDs before (AOR 1.611 95%CI [1.103–2.352]; AOR 2.329 95%CI [1.553–3.494]) or who used already antibiotics for this infection (AOR 1.597, 95%CI [1.04–2.452]) were associated with higher prescribed Ceftriaxone dosage prescribed. All of the patients recruited in this study were cured regardless of the isolates’ susceptibility to Ceftriaxone or the dosage of Ceftriaxone they received. Conclusion No Ceftriaxone failure treatment for uncomplicated gonorrhea were reported in China, however, high-dose Ceftriaxone were widely used in China, its impacts needs further studies. Disclosure No significant relationships.

Daniel F Sahm - One of the best experts on this subject based on the ideXlab platform.

  • Ceftriaxone activity against gram positive and gram negative pathogens isolated in us clinical microbiology laboratories from 1996 to 2000 results from the surveillance network tsn database usa
    International Journal of Antimicrobial Agents, 2002
    Co-Authors: James A Karlowsky, Mark E Jones, David C Mayfield, Clyde Thornsberry, Daniel F Sahm
    Abstract:

    Abstract Ceftriaxone was introduced into clinical practice in the USA in 1985 and was the first extended-spectrum (third-generation) cephalosporin approved for once-daily treatment of patients with Gram-positive or Gram-negative infections. Review of Ceftriaxone activity is important given its continued use since the mid-1980s and reports of emerging resistance among all antimicrobial agent classes. We reviewed the activity of Ceftriaxone and relevant comparative agents against five Gram-positive and 11 Gram-negative species for a 5-year period, 1996–2000, using data from The Surveillance Network® (TSN®) Database-USA. All MIC results were interpreted using NCCLS breakpoint criteria. Ceftriaxone resistance among isolates of Streptococcus pneumoniae ( n =17 219) remained essentially unchanged over the 5 years studied and in fact was lower from 1998 to 2000 (5.0–5.1%) than in 1996 (6.3%) and 1997 (6.6%). Ceftriaxone resistance (range, 5.1–6.9%) among viridans group streptococci ( n =6621) varied by Streptococcus pyogenes ( n =935) and group B β-haemolytic streptococci ( n =2267) were not identified in any year. Among methicillin-susceptible Staphylococcus aureus ( n =39 284) Ceftriaxone resistance was 0.1–0.3% per year from 1996 to 2000. Ceftriaxone resistance among Escherichia coli ( n =472 407; range, 0.2–0.4%), Klebsiella oxytoca ( n =16 231; range, 3.5–4.8%), Klebsiella pneumoniae ( n =117 754; range, 1.9–2.6%), Proteus mirabilis ( n =67 692; range, 0.2–0.3%), Morganella morganii ( n =11 251; range, 0.3–2.1%) and Serratia marcescens ( n =26 519; range, 1.6–3.8%) was low and consistent from 1996 to 2000. Resistance to Ceftriaxone among Enterobacter cloacae ( n =48 114; range, 21.7–23.9%) was relatively high, compared with other Enterobacteriaceae, but unchanged from 1996 to 2000. Rates of resistance to Ceftriaxone among Acinetobacter spp. ( n =20 813) increased from 24.8% in 1996 to 45.1% in 2000. All Haemophilus influenzae ( n =7911) and Neisseria gonorrhoeae ( n =218) were susceptible to Ceftriaxone, as were 99.7% of Moraxella catarrhalis ( n =312) tested in 1996 and 1997. In summary, Ceftriaxone has retained its potent activity against the most commonly encountered Gram-positive and Gram-negative human pathogens despite widespread and ongoing clinical use for more than 15 years.

  • Ceftriaxone activity against gram positive and gram negative pathogens isolated in us clinical microbiology laboratories from 1996 to 2000 results from the surveillance network tsn database usa
    International Journal of Antimicrobial Agents, 2002
    Co-Authors: James A Karlowsky, Mark E Jones, David C Mayfield, Clyde Thornsberry, Daniel F Sahm
    Abstract:

    Ceftriaxone was introduced into clinical practice in the USA in 1985 and was the first extended-spectrum (third-generation) cephalosporin approved for once-daily treatment of patients with Gram-positive or Gram-negative infections. Review of Ceftriaxone activity is important given its continued use since the mid-1980s and reports of emerging resistance among all antimicrobial agent classes. We reviewed the activity of Ceftriaxone and relevant comparative agents against five Gram-positive and 11 Gram-negative species for a 5-year period, 1996-2000, using data from The Surveillance Network (TSN) Database-USA. All MIC results were interpreted using NCCLS breakpoint criteria. Ceftriaxone resistance among isolates of Streptococcus pneumoniae (n=17219) remained essentially unchanged over the 5 years studied and in fact was lower from 1998 to 2000 (5.0-5.1%) than in 1996 (6.3%) and 1997 (6.6%). Ceftriaxone resistance (range, 5.1-6.9%) among viridans group streptococci (n=6621) varied by <2% from 1997 to 2000. Beta-lactam-resistant Streptococcus pyogenes (n=935) and group B beta-haemolytic streptococci (n=2267) were not identified in any year. Among methicillin-susceptible Staphylococcus aureus (n=39 284) Ceftriaxone resistance was 0.1-0.3% per year from 1996 to 2000. Ceftriaxone resistance among Escherichia coli (n=472407; range, 0.2-0.4%), Klebsiella oxytoca (n=16231; range, 3.5-4.8%), Klebsiella pneumoniae (n=117754; range, 1.9-2.6%), Proteus mirabilis (n=67692; range, 0.2-0.3%), Morganella morganii (n=11251; range, 0.3-2.1%) and Serratia marcescens (n=26519; range, 1.6-3.8%) was low and consistent from 1996 to 2000. Resistance to Ceftriaxone among Enterobacter cloacae (n=48114; range, 21.7-23.9%) was relatively high, compared with other Enterobacteriaceae, but unchanged from 1996 to 2000. Rates of resistance to Ceftriaxone among Acinetobacter spp. (n=20813) increased from 24.8% in 1996 to 45.1% in 2000. All Haemophilus influenzae (n=7911) and Neisseria gonorrhoeae (n=218) were susceptible to Ceftriaxone, as were 99.7% of Moraxella catarrhalis (n=312) tested in 1996 and 1997. In summary, Ceftriaxone has retained its potent activity against the most commonly encountered Gram-positive and Gram-negative human pathogens despite widespread and ongoing clinical use for more than 15 years.

Xiangsheng Chen - One of the best experts on this subject based on the ideXlab platform.

  • widespread use of high dose Ceftriaxone therapy for uncomplicated gonorrhea without reported Ceftriaxone treatment failure results from 5 years of multicenter surveillance data in china
    Clinical Infectious Diseases, 2020
    Co-Authors: Shaochun Chen, Ligang Yang, Na Zhong, Xiaohui Zhang, Zhizhou Wu, Liufeng Yuan, Zhongjie Zheng, Lishan Feng, Xiangsheng Chen
    Abstract:

    Background Antimicrobial resistance to Neisseria gonorrhoeae has emerged for each of the antibiotics recommended as first-line therapies following their introduction into clinical practice. To improve rational and effective clinical antibiotic treatment, we analyzed the prescription patterns of antibiotics and their therapeutic effect in the treatment of uncomplicated gonorrhea in China. Methods We obtained data from a follow-up multicenter surveillance program. Multinomial logistic regression analyses were conducted to explore the associations between demographic/clinical variables with the levels of sensitivity to Ceftriaxone and prescription of high-dose Ceftriaxone. Results In this study, 1686 patients infected with N. gonorrhoeae were recruited in a surveillance network during 1 January 2013 through 31 December 2017 in 7 hospitals distributed in 5 provinces. The prevalence of isolates with decreased susceptibility to Ceftriaxone was 9.8% (131/1333), fluctuating between 5.6% and 12.1%. Injectable Ceftriaxone was chosen as the first-line treatment among 83.1% of patients, and most of them (72.7% [1018/1401]) received >1000 mg dosage. Patients who were previously infected with gonorrhea or other sexually transmitted infections (adjusted odds ratio [AOR], 1.618 [95% confidence interval {CI}, 1.11-2.358]; AOR, 2.08 [95% CI, 1.41-3.069]) or who already used antibiotics for this infection (AOR, 1.599 [95% CI, 1.041-2.454]) were associated with a higher prescribed Ceftriaxone dosage. All of the patients recruited in this study were cured regardless of the isolates' susceptibility to Ceftriaxone or the dosage of Ceftriaxone they received. Conclusions No Ceftriaxone treatment failure for uncomplicated gonorrhea was reported in China; however, high-dose Ceftriaxone was widely used in China. Its impacts need further study.

  • p691 widespread use of high dose Ceftriaxone therapy for uncomplicated gonorrhea without reported Ceftriaxone treatment failure
    Sexually Transmitted Infections, 2019
    Co-Authors: Shaochun Chen, Xiangsheng Chen
    Abstract:

    Background Antimicrobial resistance (AMR) to N. gonorrhoeae has emerged for each of the antibiotics following their introduction into clinical practice recommended as first-line therapies. To improve rational and effective clinical antibiotic treatment, we analyzed the prescription patterns of antibiotics and its therapeutic effect in the treatment of uncomplicated gonorrhea in China. Methods We obtained data from a follow-up multicenter-surveillance program. Multinomial logistic regression analyses were conducted to explore the associations between demographic/clinical variables with the levels of sensitivity to Ceftriaxone and prescription of high-dose Ceftriaxone. Results In this study, 1686 patients infected with N. gonorrhoeae were recruited in a surveillance network during the period of 1 January 2013 through 31 December 2017 in 7 hospitals distributed in 5 provinces. The prevalence of isolates with decreased susceptibility to Ceftriaxone was 9.8% (131/1333), fluctuating between 5.6%∼12.1%. Injectable Ceftriaxone was chosen as the first-line treatment among 83.1% patients, and most of them (72.7%,1018/1401) received more than 1000 mg dosage. Patients who were infected with gonorrhea or infected with other STDs before (AOR 1.611 95%CI [1.103–2.352]; AOR 2.329 95%CI [1.553–3.494]) or who used already antibiotics for this infection (AOR 1.597, 95%CI [1.04–2.452]) were associated with higher prescribed Ceftriaxone dosage prescribed. All of the patients recruited in this study were cured regardless of the isolates’ susceptibility to Ceftriaxone or the dosage of Ceftriaxone they received. Conclusion No Ceftriaxone failure treatment for uncomplicated gonorrhea were reported in China, however, high-dose Ceftriaxone were widely used in China, its impacts needs further studies. Disclosure No significant relationships.

James A Karlowsky - One of the best experts on this subject based on the ideXlab platform.

  • Ceftriaxone activity against gram positive and gram negative pathogens isolated in us clinical microbiology laboratories from 1996 to 2000 results from the surveillance network tsn database usa
    International Journal of Antimicrobial Agents, 2002
    Co-Authors: James A Karlowsky, Mark E Jones, David C Mayfield, Clyde Thornsberry, Daniel F Sahm
    Abstract:

    Abstract Ceftriaxone was introduced into clinical practice in the USA in 1985 and was the first extended-spectrum (third-generation) cephalosporin approved for once-daily treatment of patients with Gram-positive or Gram-negative infections. Review of Ceftriaxone activity is important given its continued use since the mid-1980s and reports of emerging resistance among all antimicrobial agent classes. We reviewed the activity of Ceftriaxone and relevant comparative agents against five Gram-positive and 11 Gram-negative species for a 5-year period, 1996–2000, using data from The Surveillance Network® (TSN®) Database-USA. All MIC results were interpreted using NCCLS breakpoint criteria. Ceftriaxone resistance among isolates of Streptococcus pneumoniae ( n =17 219) remained essentially unchanged over the 5 years studied and in fact was lower from 1998 to 2000 (5.0–5.1%) than in 1996 (6.3%) and 1997 (6.6%). Ceftriaxone resistance (range, 5.1–6.9%) among viridans group streptococci ( n =6621) varied by Streptococcus pyogenes ( n =935) and group B β-haemolytic streptococci ( n =2267) were not identified in any year. Among methicillin-susceptible Staphylococcus aureus ( n =39 284) Ceftriaxone resistance was 0.1–0.3% per year from 1996 to 2000. Ceftriaxone resistance among Escherichia coli ( n =472 407; range, 0.2–0.4%), Klebsiella oxytoca ( n =16 231; range, 3.5–4.8%), Klebsiella pneumoniae ( n =117 754; range, 1.9–2.6%), Proteus mirabilis ( n =67 692; range, 0.2–0.3%), Morganella morganii ( n =11 251; range, 0.3–2.1%) and Serratia marcescens ( n =26 519; range, 1.6–3.8%) was low and consistent from 1996 to 2000. Resistance to Ceftriaxone among Enterobacter cloacae ( n =48 114; range, 21.7–23.9%) was relatively high, compared with other Enterobacteriaceae, but unchanged from 1996 to 2000. Rates of resistance to Ceftriaxone among Acinetobacter spp. ( n =20 813) increased from 24.8% in 1996 to 45.1% in 2000. All Haemophilus influenzae ( n =7911) and Neisseria gonorrhoeae ( n =218) were susceptible to Ceftriaxone, as were 99.7% of Moraxella catarrhalis ( n =312) tested in 1996 and 1997. In summary, Ceftriaxone has retained its potent activity against the most commonly encountered Gram-positive and Gram-negative human pathogens despite widespread and ongoing clinical use for more than 15 years.

  • Ceftriaxone activity against gram positive and gram negative pathogens isolated in us clinical microbiology laboratories from 1996 to 2000 results from the surveillance network tsn database usa
    International Journal of Antimicrobial Agents, 2002
    Co-Authors: James A Karlowsky, Mark E Jones, David C Mayfield, Clyde Thornsberry, Daniel F Sahm
    Abstract:

    Ceftriaxone was introduced into clinical practice in the USA in 1985 and was the first extended-spectrum (third-generation) cephalosporin approved for once-daily treatment of patients with Gram-positive or Gram-negative infections. Review of Ceftriaxone activity is important given its continued use since the mid-1980s and reports of emerging resistance among all antimicrobial agent classes. We reviewed the activity of Ceftriaxone and relevant comparative agents against five Gram-positive and 11 Gram-negative species for a 5-year period, 1996-2000, using data from The Surveillance Network (TSN) Database-USA. All MIC results were interpreted using NCCLS breakpoint criteria. Ceftriaxone resistance among isolates of Streptococcus pneumoniae (n=17219) remained essentially unchanged over the 5 years studied and in fact was lower from 1998 to 2000 (5.0-5.1%) than in 1996 (6.3%) and 1997 (6.6%). Ceftriaxone resistance (range, 5.1-6.9%) among viridans group streptococci (n=6621) varied by <2% from 1997 to 2000. Beta-lactam-resistant Streptococcus pyogenes (n=935) and group B beta-haemolytic streptococci (n=2267) were not identified in any year. Among methicillin-susceptible Staphylococcus aureus (n=39 284) Ceftriaxone resistance was 0.1-0.3% per year from 1996 to 2000. Ceftriaxone resistance among Escherichia coli (n=472407; range, 0.2-0.4%), Klebsiella oxytoca (n=16231; range, 3.5-4.8%), Klebsiella pneumoniae (n=117754; range, 1.9-2.6%), Proteus mirabilis (n=67692; range, 0.2-0.3%), Morganella morganii (n=11251; range, 0.3-2.1%) and Serratia marcescens (n=26519; range, 1.6-3.8%) was low and consistent from 1996 to 2000. Resistance to Ceftriaxone among Enterobacter cloacae (n=48114; range, 21.7-23.9%) was relatively high, compared with other Enterobacteriaceae, but unchanged from 1996 to 2000. Rates of resistance to Ceftriaxone among Acinetobacter spp. (n=20813) increased from 24.8% in 1996 to 45.1% in 2000. All Haemophilus influenzae (n=7911) and Neisseria gonorrhoeae (n=218) were susceptible to Ceftriaxone, as were 99.7% of Moraxella catarrhalis (n=312) tested in 1996 and 1997. In summary, Ceftriaxone has retained its potent activity against the most commonly encountered Gram-positive and Gram-negative human pathogens despite widespread and ongoing clinical use for more than 15 years.

Mark E Jones - One of the best experts on this subject based on the ideXlab platform.

  • Ceftriaxone activity against gram positive and gram negative pathogens isolated in us clinical microbiology laboratories from 1996 to 2000 results from the surveillance network tsn database usa
    International Journal of Antimicrobial Agents, 2002
    Co-Authors: James A Karlowsky, Mark E Jones, David C Mayfield, Clyde Thornsberry, Daniel F Sahm
    Abstract:

    Abstract Ceftriaxone was introduced into clinical practice in the USA in 1985 and was the first extended-spectrum (third-generation) cephalosporin approved for once-daily treatment of patients with Gram-positive or Gram-negative infections. Review of Ceftriaxone activity is important given its continued use since the mid-1980s and reports of emerging resistance among all antimicrobial agent classes. We reviewed the activity of Ceftriaxone and relevant comparative agents against five Gram-positive and 11 Gram-negative species for a 5-year period, 1996–2000, using data from The Surveillance Network® (TSN®) Database-USA. All MIC results were interpreted using NCCLS breakpoint criteria. Ceftriaxone resistance among isolates of Streptococcus pneumoniae ( n =17 219) remained essentially unchanged over the 5 years studied and in fact was lower from 1998 to 2000 (5.0–5.1%) than in 1996 (6.3%) and 1997 (6.6%). Ceftriaxone resistance (range, 5.1–6.9%) among viridans group streptococci ( n =6621) varied by Streptococcus pyogenes ( n =935) and group B β-haemolytic streptococci ( n =2267) were not identified in any year. Among methicillin-susceptible Staphylococcus aureus ( n =39 284) Ceftriaxone resistance was 0.1–0.3% per year from 1996 to 2000. Ceftriaxone resistance among Escherichia coli ( n =472 407; range, 0.2–0.4%), Klebsiella oxytoca ( n =16 231; range, 3.5–4.8%), Klebsiella pneumoniae ( n =117 754; range, 1.9–2.6%), Proteus mirabilis ( n =67 692; range, 0.2–0.3%), Morganella morganii ( n =11 251; range, 0.3–2.1%) and Serratia marcescens ( n =26 519; range, 1.6–3.8%) was low and consistent from 1996 to 2000. Resistance to Ceftriaxone among Enterobacter cloacae ( n =48 114; range, 21.7–23.9%) was relatively high, compared with other Enterobacteriaceae, but unchanged from 1996 to 2000. Rates of resistance to Ceftriaxone among Acinetobacter spp. ( n =20 813) increased from 24.8% in 1996 to 45.1% in 2000. All Haemophilus influenzae ( n =7911) and Neisseria gonorrhoeae ( n =218) were susceptible to Ceftriaxone, as were 99.7% of Moraxella catarrhalis ( n =312) tested in 1996 and 1997. In summary, Ceftriaxone has retained its potent activity against the most commonly encountered Gram-positive and Gram-negative human pathogens despite widespread and ongoing clinical use for more than 15 years.

  • Ceftriaxone activity against gram positive and gram negative pathogens isolated in us clinical microbiology laboratories from 1996 to 2000 results from the surveillance network tsn database usa
    International Journal of Antimicrobial Agents, 2002
    Co-Authors: James A Karlowsky, Mark E Jones, David C Mayfield, Clyde Thornsberry, Daniel F Sahm
    Abstract:

    Ceftriaxone was introduced into clinical practice in the USA in 1985 and was the first extended-spectrum (third-generation) cephalosporin approved for once-daily treatment of patients with Gram-positive or Gram-negative infections. Review of Ceftriaxone activity is important given its continued use since the mid-1980s and reports of emerging resistance among all antimicrobial agent classes. We reviewed the activity of Ceftriaxone and relevant comparative agents against five Gram-positive and 11 Gram-negative species for a 5-year period, 1996-2000, using data from The Surveillance Network (TSN) Database-USA. All MIC results were interpreted using NCCLS breakpoint criteria. Ceftriaxone resistance among isolates of Streptococcus pneumoniae (n=17219) remained essentially unchanged over the 5 years studied and in fact was lower from 1998 to 2000 (5.0-5.1%) than in 1996 (6.3%) and 1997 (6.6%). Ceftriaxone resistance (range, 5.1-6.9%) among viridans group streptococci (n=6621) varied by <2% from 1997 to 2000. Beta-lactam-resistant Streptococcus pyogenes (n=935) and group B beta-haemolytic streptococci (n=2267) were not identified in any year. Among methicillin-susceptible Staphylococcus aureus (n=39 284) Ceftriaxone resistance was 0.1-0.3% per year from 1996 to 2000. Ceftriaxone resistance among Escherichia coli (n=472407; range, 0.2-0.4%), Klebsiella oxytoca (n=16231; range, 3.5-4.8%), Klebsiella pneumoniae (n=117754; range, 1.9-2.6%), Proteus mirabilis (n=67692; range, 0.2-0.3%), Morganella morganii (n=11251; range, 0.3-2.1%) and Serratia marcescens (n=26519; range, 1.6-3.8%) was low and consistent from 1996 to 2000. Resistance to Ceftriaxone among Enterobacter cloacae (n=48114; range, 21.7-23.9%) was relatively high, compared with other Enterobacteriaceae, but unchanged from 1996 to 2000. Rates of resistance to Ceftriaxone among Acinetobacter spp. (n=20813) increased from 24.8% in 1996 to 45.1% in 2000. All Haemophilus influenzae (n=7911) and Neisseria gonorrhoeae (n=218) were susceptible to Ceftriaxone, as were 99.7% of Moraxella catarrhalis (n=312) tested in 1996 and 1997. In summary, Ceftriaxone has retained its potent activity against the most commonly encountered Gram-positive and Gram-negative human pathogens despite widespread and ongoing clinical use for more than 15 years.