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Results from the first seven months of SENTRY ANTIMICROBIAL SURVEILLANCE(1) were reported today during the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). Initial data show alarming resistance rates after an analysis of approximately 25,000 Gram-negative and Gram-positive pathogens processed at sixty-nine sites in the United States, Canada, South America and Europe.
The data are the most comprehensive evaluation of resistance patterns of both community and hospital acquired infections to date. SENTRY ANTIMICROBIAL SURVEILLANCE data indicate that pathogens are rapidly becoming more resistant as they master new ways to defeat first-line antibiotic therapies. This information will be used as a baseline for future comparisons that will ultimately provide a better understanding and predictability of resistance patterns and mechanisms.
SENTRY ANTIMICROBIAL SURVEILLANCE findings include:
-- The highest ever recorded rate (46%) of penicillin-resistant Streptococcus pneumoniae in the United States; in Europe, penicillin resistance ranged from 0.1% in Northern Europe up to greater than 30% in some Mediterranean countries.
-- Continued susceptibility to vancomycin of all methicillin- resistant Staphyloccoccus aureus isolates, suggesting that vancomycin-resistant S. aureus strains are rare and local events in certain at-risk patients.
-- The emergence of highly resistant Klebsiella species in urinary tract and pulmonary infections. In South America, these strains are three times more prevalent than in the United States and have a very high resistance (37% among urinary tract infections) to third-generation cephalosporins such as ceftazidime.
-- The highest recorded rate of vancomycin-resistant Enterococci isolates from the bloodstream (17%); in the United States, vancomycin resistance levels from this body site of infection have increased by approximately 3% in the last 12-18 months.
-- Equal prevalence of methicillin-resistant Staphyloccoccus aureus in hospitals in the United States and South America, accounting for 26%-30% of all hospital acquired S. aureus infections.
-- In Europe, methicillin resistance Staphyloccoccus aureus causing infections in intensive care units has reached 60%.
-- Unchanged rates of ampicillin-resistant Haemophilus influenzae (35%) and Moraxella catarrhalis (greater than 90%); these organisms are among the three most prevalent causes of community acquired respiratory infections.
"Physicians must know more about the spread of bacterial infections and antibiotic resistance trends occurring in their communities and hospitals in order to choose the best first-line therapy to treat the problem," said Ronald N. Jones, M.D., Department of Pathology, University of Iowa College of Medicine, one of SENTRY's chief architects. "SENTRY data is the foundation from which we can develop a better understanding of the mechanisms of resistance within pathogens and then use this information to develop new therapies and better-focused local infection control practices."
In contrast to past surveillance systems, SENTRY ANTIMICROBIAL SURVEILLANCE is the first worldwide, longitudinal (continuous) surveillance program to offer physicians, researchers and public health officials comprehensive, timely data on the most pervasive and devastating infectious diseases, including blood stream, respiratory tract, urinary tract and wound infections using standardized reference testing methods. In addition, SENTRY ANTIMICROBIAL SURVEILLANCE routinely tracks and investigates by molecular methods unusual "cluster" infection outbreaks that can have disastrous consequences.
"SENTRY provides the world's medical community with timely data on bacterial infections and antibiotic resistance patterns necessary to effectively treat and to prevent the spread of future infections," said Jan Verhoef, M.D., Institute of Medical and Clinical Microbiology, University of Utrecht. "In less than a year, SENTRY has already processed tens-of-thousands of pathogens from three continents. The data show great regional differences but make the point that no country is an island when it comes to antimicrobial resistance."
SENTRY ANTIMICROBIAL SURVEILLANCE was designed by researchers at the University of Iowa College of Medicine (USA) and the Eijkman-Winkler Institute for Microbiology Infection and Inflammation at University Hospital, Utrecht (Netherlands) and is funded by a grant from Bristol-Myers Squibb Company.
The University of Iowa College of Medicine is part of the University Health Sciences Center, which also includes the Colleges of Dentistry, Nursing and Pharmacy, as well as the Iowa City Veterans Affairs Medical Center, the University Hygienic Laboratory and the University of Iowa Hospitals and Clinics, one of the largest university-owned teaching hospitals in North America.
The University of Utrecht Hospital is the oldest teaching hospital in the Netherlands and a forerunner in promoting the status of university hospitals within the Dutch health care system. Dedicated to public health issues, the Eijkman-Winkler Institute for Microbiology Infection and Inflammation at the University of Utrecht Hospital strives to promote medical research focused on the burden of disease on patients and the prevalence of chronic disease in the general population.
Bristol-Myers Squibb Company is a diversified worldwide health and personal care company whose principal businesses are pharmaceuticals, consumer products, nutritionals and medical devices. It is a leading maker of innovative therapies for cardiovascular, metabolic and infectious diseases, central nervous system and dermatological disorders and cancer. The company is also a leader in consumer medicines, orthopedic devices, ostomy care, wound management, nutritional supplements, infant formulas and personal care products.
(1) First worldwide longitudinal surveillance program to provide timely data on both community and hospital acquired infections with standardized reference methodology.
Note to Editors: Sentry ICAAC poster presentation available on request 212/527-7453.
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CONTACT: Bryan P. Murphy 212/527-7456
Lee-Ann Murphy 212/527-7456 (In NY) 917/520-3942 At ICAAC 9/29 -- 10/1
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