UNITED-STATES GEOGRAPHIC BACTERIA SUSCEPTIBILITY PATTERNS

Emerging antimicrobial drug resistance in bacterial pathogens continue s as a worsening problem, with 1997 seeing reports of multidrug resist ant Streptococcus pneumoniae causing a nursing home outbreak in Oklaho ma (Centers for Disease Control and Prevention. Outbreaks of pneumococ cal pneumonia among unvaccinated residents in chronic-care facilities: Massachusetts, October, 1995, Oklahoma, February 1996, and Maryland, May-June 1996. MMWR Morb Mortal Wkly Rep. 1997;46:60-62) and the first report of Staphylococcus aureus no longer fully susceptible to vancom ycin hydrochloride occurring in Japan (Hiramatsu K, Hanaki H, Ino T, e t al. Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J Antimicrob Chemother. 1997;40:13 5-136). To better deal with this rapidly developing problem, we presen t the second year's national data for the United States that highlight the geographic nature of increasing resistance to antimicrobial agent s. This year we are fortunate to add the cumulative 1996 information f rom the Cleveland (Ohio) Clinic to the US survey data. All laboratorie s submitting information expended considerable effort to voluntarily c ompile the data. All participants were enthusiastic in this project an d are to be commended, along with the American Society of Clinical Pat hologists, for supporting this project. In 1996, the first areas were identified where 5% of Escherichia coli are resistant to ciprofloxacin , more than 10% of Klebsiella pneumoniae are resistant to ceftazidime, more than 10% of Enterobacter cloacae and Serratia marcescens are res istant to gentamicin, and, now, eight strains of Neisseria meningitidi s with a minimum inhibitory concentration for penicillin of > 0.06 mg/ mL have been detected. Added to the list of tables is one more emergin g hospital pathogen, Acinetobacter calcoaceticus-Acinetobacter baumann ii complex. It is more clear than ever that the future of infectious d iseases and clinical microbiology remains filled with challenge.