Survey of blood stream infections attributable to Gram-positive cocci: Frequency of occurrence and antimicrobial susceptibility of isolates collectedin 1997 in the United States, Canada, and Latin America from the SENTRY Antimicrobial Surveillance Program

The SENTRY Antimicrobial Surveillance Program was established in January, 1 997 to monitor the predominant pathogens and antimicrobial resistance patte rns of nosocomial and community-acquired infections via a network of sentin el hospitals in the United States (30 sites), Canada (eight sites), Latin A merica (10 sites), and Europe (24 sites). During the first 12-month study p eriod (January to December, 1997), a total of 9519 blood stream infections (BSI) were reported by SENTRY participants in the U.S. (6150), Canada (1727 ), and Latin America (1642). The Cram-positive cocci, Staphylococcus aureus , coagulase-negative staphylococci (CoNS), enterococci, and streptococci ac counted for 53.9% (5131 infections) of all BSI (56.5% U.S., 55.7% Canada, a nd 42.9% Latin America). The staphylococci, Enterococcus spp., S. pneumonia e, P-hemolytic streptococci, and viridans group streptococci accounted for 6 of the top 11 BSI pathogens in the U.S. and Canada, whereas only S. aureu s (Isr), CoNS (3rd), and Enterococcus spp. (9th) were among the top 12 path ogens in Latin American hospitals. The results of this survey affirm the im portance of Gram-positive cocci as causes of BSI in both North America and Latin America and demonstrate that important antimicrobial resistance Exist s among isolates of staphylococci, streptococci, and enterococci from all t hree geographic regions. This includes oxacillin-resistance among S. aureus (26.9% U.S., 29.2% Latin America, and 4.0% Canada) and CoNS (71.5% U.S., 6 8.4% Latin America,, and 65.6% Canada), penicillin resistance among viridan s group streptococci (48.5% U.S., 45.1% Canada, and 33.3% Latin America) an d pneumococci (36.2% U.S., 27.5% Canada, and 65.6% Latin America), high-lev el resistance (HLR) to aminoglycosides among enterococci (27.2 to 70.1% U.S ., 33.3 to 75.7% Canada, and 16.7 to 51.5% Latin America), and macrolide re sistance among beta-hemolytic streptococci (12.4 to 14.2% U.S., 10.5 to 12. 3% Canada, and 0.0 to 4.0% Latin America), vividans group streptococci (32. 4 to 39.7% U.S., 22.5-35.2% Canada, and 20.0% Latin America), and pneumococ ci (10.0 to 10.6% U.S., 9.8-10.8% Canada, and 9.4-18.7% Latin America). BSI isolates of Cram-positive cocci from the U.S. and Latin America were consi derably more resistant than those from Canada. New agents with Gram-positiv e activity mill be essential for optimal treatment of BSI attributable to C ram-positive cocci in both North and Latin America. (C) 1999 Elsevier Scien ce Inc.