All Hospitals Antibiogram Jan - Dec 2018 All Hospitals Antibiogram Jan - Dec 2018
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2 Cumulative atibiograms specific for idividual health care facilities ca be a useful resource for local atimicrobial stewardship groups to iform empirical therapy recommedatios ad formulary maagemet. The provisio of yearly atibiograms by health care facilities is ow required i the Natioal Safety ad Quality Health Service (NS&QHS) Stadard 3 (3.14.3).¹ This documet cotais the yearly cumulative atibiogram for all hospitals combied serviced by Sulliva Nicolaides Pathology. It is divided ito three parts 1. Uriary Atibiogram 2. No Uriary Atibiogram 3. Blood Culture Atibiogram Orgaisms are listed i descedig order of frequecy. Orgaisms are colour coded accordig to whether they are Gram or Gram Negative orgaisms. Oly the first isolate of a give species per patiet per year per subtype (e.g urie, o urie, blood cultures) is icluded. Screeig isolates collected for ifectio cotrol purposes have bee removed. Sice 2012, susceptibility testig to produce these atibiograms is performed usig EUCAST microbroth dilutio ad disc diffusio methods.² Expert EUCAST rules i Atimicrobial Susceptibility testig have bee applied.³ Where the total umber of isolates tested is < 30, results are cosidered statistically ivalid i accordace with CLSI M39-A4. ⁴ Where oly a subset (< 95%) of isolates from a particular orgaism group have bee tested, reported susceptibilities are usually ot idicative of the true susceptibility because of the selective ature of testig oly more resistat isolates. These occasios are marked with a * ad susceptibility results should be iterpreted with cautio. Sigal resistaces: At the ed of each atibiogram, sigal resistaces are summarised eve if the orgaism occurs at a frequecy too low (< 30) to appear i either the uriary, o-uriary or blood culture atibiograms. These orgaisms iclude Eterobacterales resistat to third or fourth geeratio cephalosporis due to the presece of Exteded Spectrum Beta Lactamases (ESBLs) Eterobacterales resistat to third or fourth geeratio cephalosporis due to the presece of Plasmid mediated AMPC productio (PAMPs) Eterobacterales resistat to carbapeems due to the presece of a plasmid mediated carbapeamase (CPE) No Eterobacterales (e.g Acietobacter spp; Pseudomoas aerugiosa) resistat to carbapeems due to the presece of a plasmid mediated carbapeamase (CPNE) Vacomyci resistat Eterococci (VRE) Methicilli resistat Staphylococcus aureus (MRSA) Vacomyci heteroresistat, itermediate ad resistat Staphylococcus aureus (hvisa, VISA, VRSA) Peicilli itermediate ad resistat Streptococcus peumoiae otig that breakpoits differ accordig to cliical coditio (meigitis, peumoia, other) ad mode of admiistratio Peicilli itermediate ad resistat viridas Streptococci Page: 2
3 Colour codig for all atibiograms tables is show below. Gram Orgaism Gram Negative Orgaism Atibiotic Not recommeded to be used i childre without specialist advice 90% of isolates susceptible 70-89% of isolates susceptible <70% of isolates susceptible 90% of isolates susceptible (where sample size <95% of total isolates tested) 70-89% of isolates susceptible (where sample size <95% of total isolates tested) <70% of isolates susceptible (where sample size <95% of total isolates tested) Restricted or 2d Lie Atibiotics R Itrisic Resistace is preset with this orgaism-atibiotic combiatio * Sample size <95% of the total isolates tested Restricted or 2d Lie Atibiotics ad Atibiotic Not recommeded to be used i childre without specialist advice % Percetage of isolates sesitive to this particular atibiotic Number of isolates tested with this atibiotic Refereces: Cliical ad Laboratory Stadards Istitute (CLSI). Guidelie for Aalysis ad Presetatio of Cumulative Atimicrobial Susceptibility (M39-A4). 3rd ed. Pesylvaia: CLSI, Page: 3
4 Urie Atibiogram All SNP Hospiltals Ja - Dec 2018 Orgaisms %Total Amoxicilli Amoxicilli-clavulaate Piperacilli-tazobactam Cefalexi Ceftriaxoe Ceftazidime Meropeem Getamici Amikaci Trimethoprim Nitrofuratoi Norfloxaci Ciprofloxaci Fusidic Acid Rifampici Getamici (High Level) Fosfomyci Quiupristi-dalfopristi Vacomyci All isolates Escherichia spp Eterococcus spp Klebsiella spp Pseudomoas aerugiosa Proteus mirabilis Eterobacter cloacae complex ß haemolytic Streptococci Group B Coagulase egative Staphylococci Citrobacter koseri, amaloaticus group Klebsiella aerogees % * * *389 % 89 R *1263 *1315 *1317 *1333 % R * * % R R 94 R R R R * *429 * % R * * % R R 64 R * * % *98 % R *22 *22 *23 % R * * % R R 76 R * * Page: 4
5 Urie Atibiogram All SNP Hospiltals Ja - Dec 2018 Orgaisms %Total Amoxicilli Amoxicilli-clavulaate Piperacilli-tazobactam Cefalexi Ceftriaxoe Ceftazidime Meropeem Getamici Amikaci Trimethoprim Nitrofuratoi Norfloxaci Ciprofloxaci Fusidic Acid Rifampici Getamici (High Level) Fosfomyci Quiupristi-dalfopristi Vacomyci All isolates Staphylococcus aureus (ALL) Morgaella spp Serratia spp Citrobacter freudii complex Proteus spp other % *24 *25 *25 % R R 92 R R *66 86 * % R R 98 R R *56 83 * % R R 70 R *49 60 * % R R R *29 34 * Page: 5
6 Sigal Resistaces: Where the tables below cotai o data o multiresistat orgaisms have bee detected. Urie: Exteded spectrum beta lactamase producig Eterobacterales (ESBL) Orgaism Name % of Strai Citrobacter freudii complex = 61 Citrobacter freudii Citrobacter koseri, amaloaticus group = 111 Citrobacter koseri Eterobacter cloacae complex = 234 Eterobacter cloacae Escherichia spp = 4001 Escherichia coli Klebsiella aerogees = 110 Eterobacter aerogees Klebsiella spp = 845 Klebsiella oxytoca Klebsiella peumoiae Proteus mirabilis = 328 Proteus mirabilis Proteus spp other = 34 Proteus peeri Proteus vulgaris Urie: Plasmid mediated AMPC producig Eterobacterales (PAMP) Orgaism Name % of Strai Citrobacter koseri, amaloaticus group = 111 Citrobacter koseri Escherichia spp = 4001 Escherichia coli Klebsiella spp = 845 Klebsiella oxytoca Klebsiella peumoiae Proteus mirabilis = 328 Proteus mirabilis Raoultella spp = 7 Raoultella orithiolytica Urie: Plasmid mediated Carbapeemase producig Eterobacterales (CPE) Page: 6
7 Orgaism Name % of Strai Citrobacter freudii complex = 61 Citrobacter freudii Eterobacter cloacae complex = 234 Eterobacter cloacae Urie: Plasmid mediated Carbapeemase producig No Eterobacterales (CPNE) Orgaism Name % of Strai Urie: Vacomyci Resistat Eterococci (VRE) Orgaism Name % of Strai Eterococcus spp = 1416 Eterococcus faecium (VRE) - VAN-A Eterococcus faecium (VRE) - VAN-B Urie: Methicilli Resistat Staphylococcus aureus (MRSA) Orgaism Name % of Strai Staphylococcus aureus (ALL) = 89 S.aureus (o-multiresistat MRSA) Staphylococcus aureus (MRSA) Staphylococcus aureus (UK EMRSA-15) Page: 7
8 No-urie Atibiogram All SNP Hospiltals Ja - Dec 2018 Orgaisms %Total Peicilli Amoxicilli Flucloxacilli Amoxicilli-clavulaate Piperacilli-tazobactam Cefaloti Cefazoli Ceftriaxoe Ceftazidime Cefepime Meropeem Getamici Amikaci Sulpha-trimethoprim Norfloxaci Ciprofloxaci Fusidic acid Rifampici Getamici (High Level) Erythromyci/Clarithromyci Azithromyci Clidamyci Tetracyclies Mupiroci Quiupristi-dalfopristi Vacomyci All isolates Staphylococcus aureus (ALL) Pseudomoas aerugiosa Coagulase egative Staphylococci Escherichia spp Haemophilus ifluezae viridas Streptococci Eterococcus spp Klebsiella spp Eterobacter cloacae complex % R * % R R 91 R R R * % R % * % R R * % R *101 *258 *91 * *260 % 85 R R R R R R R R *103 * * % R * % R R 67 R * Page: 8
9 No-urie Atibiogram All SNP Hospiltals Ja - Dec 2018 Orgaisms %Total Peicilli Amoxicilli Flucloxacilli Amoxicilli-clavulaate Piperacilli-tazobactam Cefaloti Cefazoli Ceftriaxoe Ceftazidime Cefepime Meropeem Getamici Amikaci Sulpha-trimethoprim Norfloxaci Ciprofloxaci Fusidic acid Rifampici Getamici (High Level) Erythromyci/Clarithromyci Azithromyci Clidamyci Tetracyclies Mupiroci Quiupristi-dalfopristi Vacomyci All isolates Steotrophomoas maltophilia Aeromoas spp ß haemolytic Streptococci Group A Campylobacter spp Moraxella catarrhalis Streptococcus peumoiae Serratia spp ß haemolytic Streptococci Other (oa ob) Spore formig GPB % R R R R R R 77 R R R 91 R * % R R *59 *114 *116 *114 *112 *118 * *115 *116 % *83 * * *85 % % % * * *88 % R R 99 R * % *71 * * *73 % *17 *48 *56 *46 95 *91 *89 Page: 9
10 No-urie Atibiogram All SNP Hospiltals Ja - Dec 2018 Orgaisms %Total Peicilli Amoxicilli Flucloxacilli Amoxicilli-clavulaate Piperacilli-tazobactam Cefaloti Cefazoli Ceftriaxoe Ceftazidime Cefepime Meropeem Getamici Amikaci Sulpha-trimethoprim Norfloxaci Ciprofloxaci Fusidic acid Rifampici Getamici (High Level) Erythromyci/Clarithromyci Azithromyci Clidamyci Tetracyclies Mupiroci Quiupristi-dalfopristi Vacomyci All isolates No fermetig GNB Proteus mirabilis Coryebacterium spp ß haemolytic Streptococci Group B Salmoella spp Helicobacter spp Fastidious GNB Pseudomoas spp Klebsiella aerogees % *70 *69 *70 *68 *64 *65 *72 *71 *47 75 *73 *10 % * % *16 *44 *13 *11 * *59 % *62 *33 69 * *58 % *63 *57 67 *59 *61 % % *31 *54 *54 *12 *33 *14 *10 *54 *30 *44 % R 9 80 R * * % R R 74 R R * Page: 10
11 No-urie Atibiogram All SNP Hospiltals Ja - Dec 2018 Orgaisms %Total Peicilli Amoxicilli Flucloxacilli Amoxicilli-clavulaate Piperacilli-tazobactam Cefaloti Cefazoli Ceftriaxoe Ceftazidime Cefepime Meropeem Getamici Amikaci Sulpha-trimethoprim Norfloxaci Ciprofloxaci Fusidic acid Rifampici Getamici (High Level) Erythromyci/Clarithromyci Azithromyci Clidamyci Tetracyclies Mupiroci Quiupristi-dalfopristi Vacomyci All isolates Morgaella spp Citrobacter koseri, amaloaticus group Acietobacter spp Citrobacter freudii complex Miscellaeous GPC % R R 89 R * % R * % R R 72 R R *31 * * % R R 48 R * % *28 *21 *20 *22 *22 *21 *20 *20 *23 *24 *22 29 Page: 11
12 Sigal Resistaces: Where the tables below cotai o data o multiresistat orgaisms have bee detected. NoUrie: Exteded spectrum beta lactamase producig Eterobacterales (ESBL) Orgaism Name % of Strai Citrobacter freudii complex = 31 Citrobacter braakii Citrobacter freudii Citrobacter koseri, amaloaticus group = 40 Citrobacter koseri Eterobacter cloacae complex = 259 Eterobacter asburiae Eterobacter cloacae Escherichia spp = 775 Escherichia coli Klebsiella aerogees = 50 Eterobacter aerogees Klebsiella spp = 312 Klebsiella peumoiae Serratia spp = 120 Serratia marcesces NoUrie: Plasmid mediated AMPC producig Eterobacterales (PAMP) Orgaism Name % of Strai Escherichia spp = 775 Escherichia coli Klebsiella spp = 312 Klebsiella oxytoca Klebsiella peumoiae Proteus mirabilis = 71 Proteus mirabilis NoUrie: Plasmid mediated Carbapeemase producig Eterobacterales (CPE) Orgaism Name % of Strai Citrobacter freudii complex = 31 Citrobacter freudii Eterobacter cloacae complex = 259 Eterobacter cloacae NoUrie: Plasmid mediated Carbapeemase producig No Eterobacterales (CPNE) Page: 12
13 Orgaism Name % of Strai NoUrie: Vacomyci Resistat Eterococci (VRE) Orgaism Name % of Strai Eterococcus spp = 317 Eterococcus faecium (VRE) - VAN-A Eterococcus faecium (VRE) - VAN-B NoUrie: Methicilli Resistat Staphylococcus aureus (MRSA) Orgaism Name % of Strai Staphylococcus aureus (ALL) = 3292 S.aureus (o-multiresistat MRSA) Staphylococcus aureus (MRSA) Staphylococcus aureus (UK EMRSA-15) NoUrie: Streptococcus peumoiae Peicilli Susceptibility (No-meigitis breakpoits) MIC category % of Strai Streptococcus peumoiae = 120 Sesitive 0.06 mg/l Itermediate mg/l Resistat > 2 mg/l NoUrie: Streptococcus peumoiae Ceftriaxoe Susceptibility MIC category % of Strai Streptococcus peumoiae = 120 Sesitive 0.5 mg/l NoUrie: Streptococcus alpha haem (viridas Streptococci) Peicilli Susceptibility Itermediate 1-2 mg/l Page: 13
14 MIC category % of Strai viridas Streptococci = 354 Sesitive 0.06 mg/l Itermediate mg/l Resistat 2 mg/l Page: 14
15 Blood Culture Atibiogram All SNP Hospiltals Ja - Dec 2018 Orgaisms %Total Peicilli Amoxicilli Flucloxacilli Amoxicilli-clavulaate Piperacilli-tazobactam Cefaloti Cefazoli Ceftriaxoe Ceftazidime Cefepime Meropeem Getamici Amikaci Sulpha-trimethoprim Ciprofloxaci Fusidic Acid Rifampici Getamici (High Level) Erythromyci/Clarithromyci Clidamyci Tetracyclies Quiupristi-dalfopristi Vacomyci All isolates Coagulase egative Staphylococci Escherichia spp Staphylococcus aureus (ALL) Klebsiella spp viridas Streptococci Pseudomoas aerugiosa Eterococcus spp Spore formig GPB Eterobacter cloacae complex % R % * % R *185 *186 * % R * % R * *25 * % R R 89 R R R 94 R * % 77 R R R R R R R R *23 *83 90 *76 90 % *54 *12 *25 *39 *21 *53 *50 *52 % R R 66 R * Page: 15
16 Blood Culture Atibiogram All SNP Hospiltals Ja - Dec 2018 Orgaisms %Total Peicilli Amoxicilli Flucloxacilli Amoxicilli-clavulaate Piperacilli-tazobactam Cefaloti Cefazoli Ceftriaxoe Ceftazidime Cefepime Meropeem Getamici Amikaci Sulpha-trimethoprim Ciprofloxaci Fusidic Acid Rifampici Getamici (High Level) Erythromyci/Clarithromyci Clidamyci Tetracyclies Quiupristi-dalfopristi Vacomyci All isolates ß haemolytic Streptococci Group B % *26 30 * *24 Sigal Resistaces: Where the tables below cotai o data o multiresistat orgaisms have bee detected. Blood Culture: Exteded spectrum beta lactamase producig Eterobacterales (ESBL) Orgaism Name % of Strai Citrobacter freudii complex = 9 Citrobacter freudii Eterobacter cloacae complex = 56 Eterobacter cloacae Escherichia spp = 407 Escherichia coli Klebsiella spp = 147 Klebsiella peumoiae Serratia spp = 21 Serratia marcesces Blood Culture: Plasmid mediated AMPC producig Eterobacterales (PAMP) Orgaism Name % of Strai Escherichia spp = 407 Escherichia coli Klebsiella spp = 147 Klebsiella peumoiae Page: 16
17 Blood Culture: Plasmid mediated Carbapeemase producig Eterobacterales (CPE) Orgaism Name % of Strai Citrobacter freudii complex = 9 Citrobacter freudii Eterobacter cloacae complex = 56 Eterobacter cloacae Blood Culture: Plasmid mediated Carbapeemase producig No Eterobacterales (CPNE) Orgaism Name % of Strai Blood Culture: Vacomyci Resistat Eterococci (VRE) Orgaism Name % of Strai Eterococcus spp = 90 Eterococcus faecium (VRE) - VAN-A Eterococcus faecium (VRE) - VAN-B Blood Culture: Methicilli Resistat Staphylococcus aureus (MRSA) Orgaism Name % of Strai Staphylococcus aureus (ALL) = 211 S.aureus (o-multiresistat MRSA) Staphylococcus aureus (MRSA) Staphylococcus aureus (UK EMRSA-15) Blood Culture: Streptococcus peumoiae Peicilli Susceptibility (No-meigitis breakpoits) MIC category % of Strai Streptococcus peumoiae = 25 Sesitive 0.06 mg/l Blood Culture: Streptococcus peumoiae Ceftriaxoe Susceptibility Itermediate mg/l Page: 17
18 MIC category % of Strai Streptococcus peumoiae = 25 Sesitive 0.5 mg/l Blood Culture: Streptococcus alpha haem (viridas Streptococci) Peicilli Susceptibility Itermediate 1-2 mg/l MIC category % of Strai viridas Streptococci = 117 Sesitive 0.06 mg/l Itermediate mg/l Resistat 2 mg/l Miscellaeous orgaism groupigs detail report. Page: 18
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