A.R.M. Program: Pseudom<strong>on</strong>as aeruginosa(2000-2008)1009080706050403020100Selective Use PressureAmikacin Gentamicin TobramycinNati<strong>on</strong>alNENJPA18
Gram-Positive OrganismsIf We Only Knew….. August 20, 1999TABLE 1. Cases of community-acquired methicillin-resistant Staphylococcus aureus,byselected characteristics -- Minnesota and North Dakota, 1997-1999 4 Characteristic pediatric Case cases: 1 Case 12m<strong>on</strong>ths-2 Case 3 13 years Case 4 RuralAgeareas7 yearsof Minnesota16 m<strong>on</strong>thsand13 yearsNorth12Dakotam<strong>on</strong>thsSyndrome septic arthritis, severe sepsis necrotizing necrotizingsepsis, pneum<strong>on</strong>ia, pneum<strong>on</strong>ia, pneum<strong>on</strong>ia/ All received β-lactam antibiotics severe sepsis which severe sepsis delayed IDempyemaof MRSAAntimicrobial t/s, tet, cip, gent, t/s, tet, cip, gent, t/s, cep, cip, gent, t/s, tet, cip,susceptibility* ery, clind, vanc ery, clind, vanc ery, clind, vanc gent, ery,clind, vanc All died of systemic MRSA infecti<strong>on</strong>Toxin test+ SEC positive SEC positive SEB positive SEB positive MIC’s to Vanc ≤ 2 mcg/ml and sensitive to multiple* t/s=trimethoprim-sulfamethoxazole, tet=tetracycline, cip=ciprofloxacin, gent=gentamicin,antibioticsery=erythromicin, clind=clindamycin, and vanc=vancomycin.+ SEB=staphylococcal enterotoxin B;SEC=staphylococcal enterotoxinMMWR MMWR 1999;48(32):707-1019