Prevalence of antimicrobial-resistant bacteria isolated from older versus younger hospitalized adults: Results of a two-centre study

Stephen G. Weber, Ram R. Miller, Eli N. Perencevich, Jocelyn Tolentino, David Meltzer, David Pitrak, Jessina C. McGregor, Greg Sachs, Anthony D. Harris, Jon P. Furuno

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives: To compare the proportion of antimicrobial-resistant strains among bacterial isolates from younger and older hospital patients and to quantify changes in the proportion of antimicrobial-resistant strains in both groups over time. Patients and methods: A retrospective analysis of microbiology data from two centres in Maryland and Chicago was performed. Adult hospital inpatients with positive clinical cultures for specific antimicrobial-resistant bacterial pathogens between 1999 and 2005 (55 427 isolates) were included. The proportions of isolates not susceptible to specific antimicrobial agents were compared between patients ≥65 and <65 years. Additional analyses examined temporal trends in the frequency of resistance and the frequency of resistance among the oldest patients (≥80 years), in bacteria isolated from blood cultures and in bacteria obtained from intensive care unit patients. Results: Heterogeneity was observed in the frequency of resistance among different bacteria between older and younger patients, between the two centres and over the study period. Staphylococcus aureus isolates were more likely to be resistant to methicillin when obtained from older patients at Chicago (50.9% versus 40.9%; P < 0.001). In contrast, younger patients yielded a greater proportion of enterococci resistant to vancomycin at Maryland (19.4% versus 16.5%; P = 0.009). Results were variable when resistance to fluoroquinolones, cephalosporins and imipenem were compared for Pseudomonas aeruginosa, Escherichia coli and Klebsiella spp. Conclusions: Overall, advanced patient age was not uniformly associated with a greater likelihood of antimicrobial resistance among all bacterial pathogens. Moreover, the frequency of resistance in older and younger patients varied considerably at the two sites over the study period. Variability in the frequency of resistance precludes simplistic conclusions regarding the relationship between age and resistance.

Original languageEnglish
Article numberdkp349
Pages (from-to)1291-1298
Number of pages8
JournalJournal of Antimicrobial Chemotherapy
Volume64
Issue number6
DOIs
StatePublished - Sep 24 2009

Fingerprint

Young Adult
Bacteria
Methicillin Resistance
Klebsiella
Imipenem
Fluoroquinolones
Cephalosporins
Anti-Infective Agents
Microbiology
Pseudomonas aeruginosa
Intensive Care Units
Staphylococcus aureus
Inpatients
Escherichia coli

Keywords

  • Age
  • Bacterial
  • Drug resistance

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases
  • Medicine(all)

Cite this

Weber, S. G., Miller, R. R., Perencevich, E. N., Tolentino, J., Meltzer, D., Pitrak, D., ... Furuno, J. P. (2009). Prevalence of antimicrobial-resistant bacteria isolated from older versus younger hospitalized adults: Results of a two-centre study. Journal of Antimicrobial Chemotherapy, 64(6), 1291-1298. [dkp349]. https://doi.org/10.1093/jac/dkp349

Prevalence of antimicrobial-resistant bacteria isolated from older versus younger hospitalized adults : Results of a two-centre study. / Weber, Stephen G.; Miller, Ram R.; Perencevich, Eli N.; Tolentino, Jocelyn; Meltzer, David; Pitrak, David; McGregor, Jessina C.; Sachs, Greg; Harris, Anthony D.; Furuno, Jon P.

In: Journal of Antimicrobial Chemotherapy, Vol. 64, No. 6, dkp349, 24.09.2009, p. 1291-1298.

Research output: Contribution to journalArticle

Weber, SG, Miller, RR, Perencevich, EN, Tolentino, J, Meltzer, D, Pitrak, D, McGregor, JC, Sachs, G, Harris, AD & Furuno, JP 2009, 'Prevalence of antimicrobial-resistant bacteria isolated from older versus younger hospitalized adults: Results of a two-centre study', Journal of Antimicrobial Chemotherapy, vol. 64, no. 6, dkp349, pp. 1291-1298. https://doi.org/10.1093/jac/dkp349
Weber, Stephen G. ; Miller, Ram R. ; Perencevich, Eli N. ; Tolentino, Jocelyn ; Meltzer, David ; Pitrak, David ; McGregor, Jessina C. ; Sachs, Greg ; Harris, Anthony D. ; Furuno, Jon P. / Prevalence of antimicrobial-resistant bacteria isolated from older versus younger hospitalized adults : Results of a two-centre study. In: Journal of Antimicrobial Chemotherapy. 2009 ; Vol. 64, No. 6. pp. 1291-1298.
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abstract = "Objectives: To compare the proportion of antimicrobial-resistant strains among bacterial isolates from younger and older hospital patients and to quantify changes in the proportion of antimicrobial-resistant strains in both groups over time. Patients and methods: A retrospective analysis of microbiology data from two centres in Maryland and Chicago was performed. Adult hospital inpatients with positive clinical cultures for specific antimicrobial-resistant bacterial pathogens between 1999 and 2005 (55 427 isolates) were included. The proportions of isolates not susceptible to specific antimicrobial agents were compared between patients ≥65 and <65 years. Additional analyses examined temporal trends in the frequency of resistance and the frequency of resistance among the oldest patients (≥80 years), in bacteria isolated from blood cultures and in bacteria obtained from intensive care unit patients. Results: Heterogeneity was observed in the frequency of resistance among different bacteria between older and younger patients, between the two centres and over the study period. Staphylococcus aureus isolates were more likely to be resistant to methicillin when obtained from older patients at Chicago (50.9{\%} versus 40.9{\%}; P < 0.001). In contrast, younger patients yielded a greater proportion of enterococci resistant to vancomycin at Maryland (19.4{\%} versus 16.5{\%}; P = 0.009). Results were variable when resistance to fluoroquinolones, cephalosporins and imipenem were compared for Pseudomonas aeruginosa, Escherichia coli and Klebsiella spp. Conclusions: Overall, advanced patient age was not uniformly associated with a greater likelihood of antimicrobial resistance among all bacterial pathogens. Moreover, the frequency of resistance in older and younger patients varied considerably at the two sites over the study period. Variability in the frequency of resistance precludes simplistic conclusions regarding the relationship between age and resistance.",
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AU - Tolentino, Jocelyn

AU - Meltzer, David

AU - Pitrak, David

AU - McGregor, Jessina C.

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N2 - Objectives: To compare the proportion of antimicrobial-resistant strains among bacterial isolates from younger and older hospital patients and to quantify changes in the proportion of antimicrobial-resistant strains in both groups over time. Patients and methods: A retrospective analysis of microbiology data from two centres in Maryland and Chicago was performed. Adult hospital inpatients with positive clinical cultures for specific antimicrobial-resistant bacterial pathogens between 1999 and 2005 (55 427 isolates) were included. The proportions of isolates not susceptible to specific antimicrobial agents were compared between patients ≥65 and <65 years. Additional analyses examined temporal trends in the frequency of resistance and the frequency of resistance among the oldest patients (≥80 years), in bacteria isolated from blood cultures and in bacteria obtained from intensive care unit patients. Results: Heterogeneity was observed in the frequency of resistance among different bacteria between older and younger patients, between the two centres and over the study period. Staphylococcus aureus isolates were more likely to be resistant to methicillin when obtained from older patients at Chicago (50.9% versus 40.9%; P < 0.001). In contrast, younger patients yielded a greater proportion of enterococci resistant to vancomycin at Maryland (19.4% versus 16.5%; P = 0.009). Results were variable when resistance to fluoroquinolones, cephalosporins and imipenem were compared for Pseudomonas aeruginosa, Escherichia coli and Klebsiella spp. Conclusions: Overall, advanced patient age was not uniformly associated with a greater likelihood of antimicrobial resistance among all bacterial pathogens. Moreover, the frequency of resistance in older and younger patients varied considerably at the two sites over the study period. Variability in the frequency of resistance precludes simplistic conclusions regarding the relationship between age and resistance.

AB - Objectives: To compare the proportion of antimicrobial-resistant strains among bacterial isolates from younger and older hospital patients and to quantify changes in the proportion of antimicrobial-resistant strains in both groups over time. Patients and methods: A retrospective analysis of microbiology data from two centres in Maryland and Chicago was performed. Adult hospital inpatients with positive clinical cultures for specific antimicrobial-resistant bacterial pathogens between 1999 and 2005 (55 427 isolates) were included. The proportions of isolates not susceptible to specific antimicrobial agents were compared between patients ≥65 and <65 years. Additional analyses examined temporal trends in the frequency of resistance and the frequency of resistance among the oldest patients (≥80 years), in bacteria isolated from blood cultures and in bacteria obtained from intensive care unit patients. Results: Heterogeneity was observed in the frequency of resistance among different bacteria between older and younger patients, between the two centres and over the study period. Staphylococcus aureus isolates were more likely to be resistant to methicillin when obtained from older patients at Chicago (50.9% versus 40.9%; P < 0.001). In contrast, younger patients yielded a greater proportion of enterococci resistant to vancomycin at Maryland (19.4% versus 16.5%; P = 0.009). Results were variable when resistance to fluoroquinolones, cephalosporins and imipenem were compared for Pseudomonas aeruginosa, Escherichia coli and Klebsiella spp. Conclusions: Overall, advanced patient age was not uniformly associated with a greater likelihood of antimicrobial resistance among all bacterial pathogens. Moreover, the frequency of resistance in older and younger patients varied considerably at the two sites over the study period. Variability in the frequency of resistance precludes simplistic conclusions regarding the relationship between age and resistance.

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