Rapidly rising prevalence of nosocomial multidrug-resistant, Gram-negative bacilli: a 9-year surveillance study

Infect Control Hosp Epidemiol. 2004 Oct;25(10):842-6. doi: 10.1086/502306.


Objective: To examine and quantify the temporal trends of nosocomial multidrug-resistant, gram-negative bacilli.

Design: A 9-year surveillance study was conducted. Multidrug resistance was defined as resistance to 3 or more antimicrobial classes.

Setting: Tertiary-care institution.

Results: From 1994 to 2002, multidrug-resistant, gram-negative bacilli increased from 1% to 16% for multidrug-resistant Pseudomonas aeruginosa, 4% to 13% for multidrug-resistant Enterobacter species, 0.5% to 17% for multidrug-resistant Klebsiella species, 0% to 9% for multidrug-resistant Proteus species, and 0.2% to 4% for multidrug-resistant Escherichia coli (P < or = .05). The most common pattern of multidrug resistance was co-resistance to quinolones, third-generation cephalosporins, and aminoglycosides.

Conclusion: The rapid rise of multidrug-resistant, gram-negative bacilli may warrant infection control programs to include these pathogens in strategies aimed at limiting the emergence and spread of antimicrobial-resistant pathogens.

MeSH terms

  • Cross Infection / epidemiology*
  • Drug Resistance, Multiple, Bacterial*
  • Enterobacter
  • Enterobacteriaceae Infections / epidemiology
  • Escherichia coli Infections / epidemiology
  • Gram-Negative Bacterial Infections / epidemiology*
  • Klebsiella Infections / epidemiology
  • Prevalence
  • Proteus Infections / epidemiology
  • Pseudomonas Infections / epidemiology
  • Pseudomonas aeruginosa