Therapeutic and epidemiologic recommendations to reduce the spread of type-I beta-lactamase resistance

H. C. Neu, R. J. Duma, R. N. Jones, J. E. Jr McGowan, T. F. O'Brien, L. D. Sabath, C. C. Sanders, W. Schaffner, F. C. Tenover, L. S. Young

Research output: Contribution to journalArticle

Abstract

The objectives of this United States Consensus Panel meeting were to evaluate the effectiveness of current surveillance systems for the detection of bacterial resistance as well as to formulate recommendations that can assist hospitals in determining actions that should be taken when a resistance problem is detected. These recommendations may be particularly helpful in controlling the emergence and spread of type-I beta-lactamase resistance. Numerous case reports of antimicrobial resistance among Enterobacter species, Pseudomonas aeruginosa, and other Gram-negative nosocomial pathogens known to produce type-I beta-lactamases have appeared in the literature since the introduction of the newer "third-generation" cephalosporins. The widespread use of these newer antimicrobial agents, often selected as standard therapy for serious hospital-acquired infections, has been associated with a corresponding increase in resistance to them. The failure of hospitalwide surveillance methods to describe the scope of this problem, especially among the most critically ill patients, may have resulted in a false sense of security among some infectious disease specialists and clinicians prescribing these antimicrobials as empiric therapy. High-level resistance in individual hospital units may be masked in hospitalwide antibiograms. A variety of conclusions and recommendations were formulated based on the collective experiences of the Consensus Panel members. Microbiology laboratories must make it a high priority to identify markers that will assist in rapidly identifying resistant organisms. Cooperative efforts are needed among users of commercial and automated microbiology test instruments to standardize results and to improve quality control, thereby making the data more directly comparable between laboratories.(ABSTRACT TRUNCATED AT 250 WORDS) [References: 2]
Original languageUndefined/Unknown
Pages (from-to)49S-52S
JournalDiagnostic Microbiology and Infectious Disease
Volume15
Issue number2 Suppl
StatePublished - 1992

Keywords

  • Anti-Bacterial Agents/pd [Pharmacology]
  • Cross Infection/dt [Drug Therapy]
  • Cross Infection/ep [Epidemiology]
  • Cross Infection/mi [Microbiology]
  • Drug Resistance, Microbial
  • Penicillinase
  • beta-Lactams

Cite this

Neu, H. C., Duma, R. J., Jones, R. N., McGowan, J. E. J., O'Brien, T. F., Sabath, L. D., ... Young, L. S. (1992). Therapeutic and epidemiologic recommendations to reduce the spread of type-I beta-lactamase resistance. Diagnostic Microbiology and Infectious Disease, 15(2 Suppl), 49S-52S.

Therapeutic and epidemiologic recommendations to reduce the spread of type-I beta-lactamase resistance. / Neu, H. C.; Duma, R. J.; Jones, R. N.; McGowan, J. E. Jr; O'Brien, T. F.; Sabath, L. D.; Sanders, C. C.; Schaffner, W.; Tenover, F. C.; Young, L. S.

In: Diagnostic Microbiology and Infectious Disease, Vol. 15, No. 2 Suppl, 1992, p. 49S-52S.

Research output: Contribution to journalArticle

Neu, HC, Duma, RJ, Jones, RN, McGowan, JEJ, O'Brien, TF, Sabath, LD, Sanders, CC, Schaffner, W, Tenover, FC & Young, LS 1992, 'Therapeutic and epidemiologic recommendations to reduce the spread of type-I beta-lactamase resistance' Diagnostic Microbiology and Infectious Disease, vol. 15, no. 2 Suppl, pp. 49S-52S.
Neu, H. C. ; Duma, R. J. ; Jones, R. N. ; McGowan, J. E. Jr ; O'Brien, T. F. ; Sabath, L. D. ; Sanders, C. C. ; Schaffner, W. ; Tenover, F. C. ; Young, L. S. / Therapeutic and epidemiologic recommendations to reduce the spread of type-I beta-lactamase resistance. In: Diagnostic Microbiology and Infectious Disease. 1992 ; Vol. 15, No. 2 Suppl. pp. 49S-52S.
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AU - Neu, H. C.

AU - Duma, R. J.

AU - Jones, R. N.

AU - McGowan, J. E. Jr

AU - O'Brien, T. F.

AU - Sabath, L. D.

AU - Sanders, C. C.

AU - Schaffner, W.

AU - Tenover, F. C.

AU - Young, L. S.

PY - 1992

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N2 - The objectives of this United States Consensus Panel meeting were to evaluate the effectiveness of current surveillance systems for the detection of bacterial resistance as well as to formulate recommendations that can assist hospitals in determining actions that should be taken when a resistance problem is detected. These recommendations may be particularly helpful in controlling the emergence and spread of type-I beta-lactamase resistance. Numerous case reports of antimicrobial resistance among Enterobacter species, Pseudomonas aeruginosa, and other Gram-negative nosocomial pathogens known to produce type-I beta-lactamases have appeared in the literature since the introduction of the newer "third-generation" cephalosporins. The widespread use of these newer antimicrobial agents, often selected as standard therapy for serious hospital-acquired infections, has been associated with a corresponding increase in resistance to them. The failure of hospitalwide surveillance methods to describe the scope of this problem, especially among the most critically ill patients, may have resulted in a false sense of security among some infectious disease specialists and clinicians prescribing these antimicrobials as empiric therapy. High-level resistance in individual hospital units may be masked in hospitalwide antibiograms. A variety of conclusions and recommendations were formulated based on the collective experiences of the Consensus Panel members. Microbiology laboratories must make it a high priority to identify markers that will assist in rapidly identifying resistant organisms. Cooperative efforts are needed among users of commercial and automated microbiology test instruments to standardize results and to improve quality control, thereby making the data more directly comparable between laboratories.(ABSTRACT TRUNCATED AT 250 WORDS) [References: 2]

AB - The objectives of this United States Consensus Panel meeting were to evaluate the effectiveness of current surveillance systems for the detection of bacterial resistance as well as to formulate recommendations that can assist hospitals in determining actions that should be taken when a resistance problem is detected. These recommendations may be particularly helpful in controlling the emergence and spread of type-I beta-lactamase resistance. Numerous case reports of antimicrobial resistance among Enterobacter species, Pseudomonas aeruginosa, and other Gram-negative nosocomial pathogens known to produce type-I beta-lactamases have appeared in the literature since the introduction of the newer "third-generation" cephalosporins. The widespread use of these newer antimicrobial agents, often selected as standard therapy for serious hospital-acquired infections, has been associated with a corresponding increase in resistance to them. The failure of hospitalwide surveillance methods to describe the scope of this problem, especially among the most critically ill patients, may have resulted in a false sense of security among some infectious disease specialists and clinicians prescribing these antimicrobials as empiric therapy. High-level resistance in individual hospital units may be masked in hospitalwide antibiograms. A variety of conclusions and recommendations were formulated based on the collective experiences of the Consensus Panel members. Microbiology laboratories must make it a high priority to identify markers that will assist in rapidly identifying resistant organisms. Cooperative efforts are needed among users of commercial and automated microbiology test instruments to standardize results and to improve quality control, thereby making the data more directly comparable between laboratories.(ABSTRACT TRUNCATED AT 250 WORDS) [References: 2]

KW - Anti-Bacterial Agents/pd [Pharmacology]

KW - Cross Infection/dt [Drug Therapy]

KW - Cross Infection/ep [Epidemiology]

KW - Cross Infection/mi [Microbiology]

KW - Drug Resistance, Microbial

KW - Penicillinase

KW - beta-Lactams

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JO - Diagnostic Microbiology and Infectious Disease

JF - Diagnostic Microbiology and Infectious Disease

SN - 0732-8893

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