Summary
In 1990–1991, in a national surveillance study of bacterial resistance, ciprofloxacin data from geographic and demographically diverse institutions were collected. Most of the isolates were from hospitalized patients. Ciprofloxacin susceptibility was obtained on 154,689 clinical isolates comprising 48 genera and 128 species or groups; 60.2% of the species or groups and 62.3% of the isolates were gram-negative. MIC tests and identification tests also were performed on 12,012 of these isolates, which had been submitted to our in-house laboratory. For all surveillance isolates, 88.2% were susceptible, 4.6% were moderately susceptible, and 7.2% were resistant to ciprofloxacin. Most isolates (96.2%) of the surveillanceEnterobacteriaceae were susceptible to ciprofloxacin, as were 87.7% of thePseudomonas aeruginosa (7.8% resistant). A majority of the methicillin-susceptible strains ofStaphylococcus aureus were susceptible (95.7%) or moderately susceptible (1.4%) to ciprofloxacin. But a majority of methicillin-resistant isolates were resistant (76.4%) to ciprofloxacin. Most of the pneumococci (96.5%) were susceptible or moderately susceptible to ciprofloxacin with 92.7% of these isolates having MICs of 1 mg/l (susceptible) or 2 mg/l (moderately susceptible). The ciprofloxacin data for the isolates tested in our in-house laboratory generally confirmed the susceptibility rates of those from the surveillance data. This study shows that, with the exception of methicillin-resistant staphylococci, ciprofloxacin has retained a high level of activity against most bacterial pathogens.
Zusammenfassung
In einer nationalen Überwachungsstudie zur bakteriellen Resistenz wurden Daten für Ciprofloxacin aus geographisch und demographisch unterschiedlichen Institutionen gesammelt. Die meisten Isolate waren von hospitalisierten Patienten. Für die Empfindlichkeitstestung gegenüber Ciprofloxacin standen 154 689 klinische Isolate von 48 Genera und 128 Spezies oder Gruppen zur Verfügung. 60,2% der Spezies oder Gruppen und 62,3% der Isolate waren gramnegativ. Bei 12 012 Isolaten, die in unser Kliniklabor eingesandt wurden, wurden MHK-Tests und Identifizierung vorgenommen. Von allen Isolaten der Überwachungsstudie waren 88,2% empfindlich, 4,6% mäßig empfindlich und 7,2 resistent gegen Ciprofloxacin. Die meisten Enterobacteriaceac-Isolate (96,2%) waren gegen Ciprofloxacin empfindlich; vonPseudomonas aeruginosa waren 87,7% empfindlich, und 7,8% resistent. Der überwiegende Anteil der methicillinempfindlichen Stämme vonStaphylococcus aureus war empfindlich (95,7%) oder mäßig empfindlich (1,4%) gegen Ciprofloxacin. Unter den methicillinresistenten Isolaten war hingegen der größte Teil resistent gegen Ciprofloxacin (76,4%). Die meisten Pneumokokken (96,5%) waren gegen Ciprofloxacin empfindlich oder mäßig empfindlich; die MHK-Werte lagen bei 92,7% der Isolate bei 1 mg/l (empfindlich) oder 2 mg/l (mäßig empfindlich). Die in unserem Labor durchgeführten Empfindlichkeitsprüfungen für Ciprofloxacin bestätigten im allgemeinen die Daten der Überwachungsstudie. Diese Studie zeigt, daß Ciprofloxacin mit Ausnahme der methicillinresistenten Staphylokokken gegen die meisten bakteriellen Erreger seine hohe Aktivität erhalten hat.
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References
Neu, H. C. Bacterial resistance to fluoroquinolones. Rev. Infect. Dis. 10 (1988) 57–63.
Satta, G., Siddu, D., Cornaglia, G., Pruna, M. Ciprofloxacin and resistance to antibiotics in gram-positive and gram-negative bacteria. Rev. Infect. Dis. 10 (1988) 65–66.
Frei, R., Bindschedler, M., Stalder, H., Reber, H., Follath, F. Emergence of resistance to ciprofloxacin during therapy. Rev. Infect. Dis. 10 (1988) 68.
Chin, N. X., Clynes, N., Neu, H. C. Resistance to ciprofloxacin appearing during therapy. Am. J. Med. 87 (1989) 28–31.
Baillie, L. Ciprofloxacin resistantPseudomonas aeruginosa strain (letter). Med. Lab. Sci. 46 (1989) 92–93.
Wiedemann, B., Zühlsdorf, M. T. Brief Report: resistance development to fluoroquinolones in Europe. Am. J. Med. 87 (1989) 9–11.
Kresken, M., Wiedemann, B. Development of resistance to nalidixic acid and the fluoroquinolones after the introduction of norfloxacin and ofloxacin. Antimicrob. Agents Chemother. 32 (1988) 1285–1288.
Raviglione, M. C., Boyle, J. F., Mariuz, P., Pablos-Mendez, A., Cortes, J., Merlo, A. Ciprofloxacin-resistant methicillin-resistantStaphylococcus aureus in an acute-care hospital. Antimicrob. Agents Chemother. 34 (1990) 2050–2054.
Daum, T. E., Schaberg, D. R., Terpenning, M. S., Sottile, W. S., Kaufmann, C. A. Increasing resistance ofStaphylococcus aureus to ciprofloxacin. Antimicrob. Agents Chemother. 34 (1990) 1862–1863.
Chamberland, S., Malouin, F., Rabin, H. R., Schollaardt, T., Parr, T. R. Hr., Bryan, L. E. Persistence ofPseudomonas aeruginosa during ciprofloxacin therapy of a cystic fibrosis patient: transient resistance to quinolones and protein F-deficiency. J. Antimicrob. Chemother. 25 (1990) 995–1010.
Peterson, L. R., Quick, J. N., Jensen, B., Homann, S., Johnson, S., Tenquist, J., Shanholtzer, C., Petzel, R. A., Sinn, L., Gerding, D. N. Emergence of ciprofloxacin resistance in nosocomial methicillin-resistantStaphylococcus aureus isolates. Resistance during ciprofloxacin plus rifampin therapy for methicillin-resistantS. aureus colonization. Arch. Intern. Med. 150 (1990) 2151–2155.
Ball, P. Emergent resistance to ciprofloxacin amongstPseudomonas aeruginosa andStaphylococcus aureus: clinical significance and therapeutic approaches. J. Antimicrob. Chemother. 26 Suppl. F (1990) 165–179.
Blumberg, H. M.;Rimland, D., Carroll, D. J., Terry, P., Wachsmuth, I. K. Rapid development of ciprofloxacin resistance in methicillin-susceptible and -resistantStaphylococcus aureus. J. Infect. Dis. 163 (1991) 1279–1285.
National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically — second edition, 10 (1990).
McDougal, L. K., Thornsberry, C. The role of β-lactamase in staph-ylococcal resistance to penicillinase-resistant penicillins and cephalosporins. J. Clin. Microbiol. 23 (1986) 832.
Wolfson, J. S., Hooper, D. C. Bacterial resistance to quinolones: mechanisms and clinical importance. Rev. Infect. Dis. 11 (1989) 960–968.
Hooper, D. C., Wolfson, J. S. Mode of action of the new quinolones: new data. Eur. J. Clin. Microbiol. Infect. Dis. 10 (1991) 223–231.
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Thornsberry, C. Susceptibility of clinical bacterial isolates to ciprofloxacin in the united states. Infection 22 (Suppl 2), S80–S89 (1994). https://doi.org/10.1007/BF01793571
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DOI: https://doi.org/10.1007/BF01793571