TORONTOA worldwide, longitudinal surveillance program of antimicrobial resistance, known as Sentry, is showing alarming resistance rates at sites in the United States, Canada, South America, and Europe, and some interesting geographical differences.
The data were presented by Ronald Jones, MD, of the University of Iowa College of Medicine, Iowa City, at the 37th ICAAC. The program, initiated earlier this year and supported by a grant from Bristol-Myers Squibb, is monitoring resistance to more than 70 antimicrobial agents at 68 medical centers around the world. Interesting findings include:
- High rates of penicillin-resistant Streptococcus pneumoniae in the United States (46%) and Canada (31%) but not Northern Europe (0.1%).
- Emergence of highly resistant Klebsiella species in urinary tract and pulmonary infections. These strains are three times more prevalent in South America than in the US and have a high resistance to third-generation cephalosporins.
- High rates of vancomycin-resistant Enterococci isolates from the bloodstream (17%), increasing in the US by approximately 3% in the last 12 to 18 months.
- Equal prevalence of methicillin-resistant Staphylococcus aureus in hospitals in the US and South America, accounting for 26% to 30% of all nosocomial S aureus infections. In Europe, methicillin-resistant S aureus infections in some ICUs has reached 60%. However, methicillin-resistant S aureus isolates continue to show susceptibility to vancomycin.