Antimicrobial Susceptibility Testing: Advanced Course

Size: px
Start display at page:

Download "Antimicrobial Susceptibility Testing: Advanced Course"

Transcription

1 Antimicrobial Susceptibility Testing: Advanced Course

2 Cascade Reporting

3 Cascade Reporting I. Selecting Antimicrobial Agents for Testing and Reporting Selection of the most appropriate antimicrobials to test & report is a decision best made by each clinical laboratory in consultation with: Infectious disease practitioners Pharmacy Pharmacy & Therapeutics committee Infection Control committee Considerations of antimicrobials include: clinical efficacy prevalence of resistance (& minimizing the emergence of resistance) cost FDA clinical indications for use current consensus for first-choice and alternative drugs tests of selected agents may be useful for infection control purposes

4 Test/Report Groups. Group A are considered appropriate for inclusion in a routine, primary testing panel, as well as for routine reporting of results for the specific organism groups. 2. Group B includes antimicrobial agents that may warrant primary testing but they may be reported only selectively, such as when the organism is resistant to agents of the same antimicrobial class, as in Group A. Other indications for reporting the result might include a selected specimen source (eg, a third-generation cephalosporin for enteric bacilli from cerebrospinal fluid or trimethoprim-sulfamethoxazole for urinary tract isolates); a polymicrobial infection; infections involving multiple sites; cases of patient allergy, intolerance, or failure to respond to an agent in Group A; or for purposes of infection control.. Group C includes alternative or supplemental antimicrobial agents that may require testing in those institutions that harbor endemic or epidemic strains resistant to several of the primary drugs (especially in the same class, eg, -lactams); for treatment of patients allergic to primary drugs; for treatment of unusual organisms (eg, chloramphenicol for extraintestinal isolates of Salmonella spp.); or for reporting to infection control as an epidemiological aid.. Group U ( urine ) includes antimicrobial agents (eg, nitrofurantoin and certain quinolones) that are used only or primarily for treating urinary tract infections. These agents should not be routinely reported against pathogens recovered from other sites of infection. Other agents with broader indications may be included in Group U for specific urinary pathogens (eg, P. aeruginosa and ofloxacin). 5. Group O ( other ) includes antimicrobial agents that have a clinical indication for the organism group, but are generally not candidates for routine testing and reporting in the United States. 6. Group Inv. ( investigational ) includes antimicrobial agents that are investigational for the organism group and have not yet been approved by the FDA for use in the United States.

5 Cascade Reporting I. Selecting Antimicrobial Agents for Testing and Reporting Group A appropriate for inclusion in a routine, primary testing panel, appropriate for routine reporting of results for the specific organism groups

6 GROUP A PRIMARY TEST AND REPORT Cascade Reporting Table A. Enterobacteriaceae Pseudomonas aeruginosa Staphylococcus spp. Ampicillin d Ceftazidime Azithromycin b or clarithromycin b or erythromycin b Cefazolin e Gentamicin Tobramycin Gentamicin Tobramycin Piperacillin Clindamycin b *, Oxacillin i,k Cefoxitin i,k (surrogate test for oxacillin) Penicillin i Trimethoprimsulfamethoxazole Enterococcus spp. m Ampicillin n Penicillin o

7 GROUP A PRIMARY TEST AND REPORT Report routinely Cascade Reporting Table A. Enterobacteriaceae Pseudomonas aeruginosa Staphylococcus spp. Ampicillin d Ceftazidime Azithromycin b or clarithromycin b or erythromycin b Cefazolin e Gentamicin Tobramycin Gentamicin Tobramycin Piperacillin/ tazobactam Clindamycin b *, Oxacillin i,k Cefoxitin i,k (surrogate test for oxacillin) Penicillin i Trimethoprimsulfamethoxazole Enterococcus spp. m Ampicillin n Penicillin o

8 Cascade Reporting I. Selecting Antimicrobial Agents for Testing and Reporting 2. Group B includes antimicrobial agents that may warrant primary testing but they may be reported only selectively, such as when the organism is resistant to agents of the same antimicrobial class in Group A. Other indications for reporting: selected specimen source (urine), failure to respond to an agent in Group A, or for purposes of infection control

9 GROUP B PRIMARY TEST REPORT SELECTIVELY Table A. Cascade Reporting Enterobacteriaceae Amikacin Amikacin Ceftaroline h *Daptomycin j *Daptomycin j Aztreonam Linezolid Linezolid Amoxicillin-clavulanate Ampicillin-sulbactam Piperacillin-tazobactam Ticarcillin-clavulanate Cefuroxime Cefepime Pseudomonas aeruginosa Staphylococcus spp. Doxycycline Minocycline b Tetracycline a Enterococcus spp. m Vancomycin Cefepime Cefotetan Cefoxitin Cefotaxime d,e or ceftriaxone d,e Ciprofloxacin d Levofloxacin d Doripenem Ertapenem Imipenem Meropenem Piperacillin Trimethoprim-sulfamethoxazole d Ciprofloxacin Levofloxacin Doripenem Imipenem Meropenem Piperacillin-tazobactam Ticarcillin *, Vancomycin Rifampin g

10 GROUP B PRIMARY TEST REPORT SELECTIVELY Table A. Cascade Reporting Report routinely Test routinely *Cascade reported Enterobacteriaceae Amikacin* Amikacin* Ceftaroline h *Daptomycin j * *Daptomycin j * Aztreonam Linezolid* Linezolid* Amoxicillin-clavulanate* Ampicillin-sulbactam Piperacillin-tazobactam Ticarcillin-clavulanate Cefuroxime Cefepime Pseudomonas aeruginosa Staphylococcus spp. Doxycycline* Minocycline b Tetracycline a Enterococcus spp. m Vancomycin Cefepime* Cefotetan Cefoxitin Cefotaxime d,e or ceftriaxone d,e * Ciprofloxacin d Levofloxacin d Doripenem Ertapenem* Imipenem Meropenem* Piperacillin Trimethoprim-sulfamethoxazole d Ciprofloxacin Levofloxacin Doripenem Imipenem Meropenem Piperacillin-tazobactam Ticarcillin *, Vancomycin Rifampin g *

11 Cascade Reporting I. Selecting Antimicrobial Agents for Testing and Reporting. Group C includes alternative or supplemental antimicrobial agents that may require testing in those institutions that harbor endemic or epidemic strains resistant to several of the primary drugs, for treatment of patients allergic to primary drugs, for treatment of unusual organisms, or for reporting to infection control as an epidemiological aid

12 GROUP C SUPPLEMENTAL REPORT SELECTIVELY Table A. Cascade Reporting Enterobacteriaceae Aztreonam Ceftazidime Pseudomonas aeruginosa Staphylococcus spp. Chloramphenicol b Enterococcus spp. m Gentamicin (high-level resistance screen only) Ceftaroline Ciprofloxacin or levofloxacin or ofloxacin Moxifloxacin Streptomycin (high-level resistance screen only) Chloramphenicol b,d Gentamicin l Tetracycline a

13 GROUP C SUPPLEMENTAL REPORT SELECTIVELY Table A. Cascade Reporting Report routinely Test routinely Selectively reported Enterobacteriaceae Aztreonam Ceftazidime* Pseudomonas aeruginosa Staphylococcus spp. Chloramphenicol b Enterococcus spp. m Gentamicin (high-level resistance screen only) Ceftaroline Ciprofloxacin or levofloxacin or ofloxacin Moxifloxacin Streptomycin (high-level resistance screen only) Chloramphenicol b,d Gentamicin l Tetracycline a *

14 Clindamycin Erythromycin Oxacillin Vancomycin Chloramphenicol Cefazolin Penicillin Ceftriaxone Moxifloxacin Tetracycline Ampicillin Linezolid SXT Levofloxacin Gent Synergy Cascade Reporting: GPC Non-urine/Non-CSF Staphylococcus species (V2) R 2, 5 Streptococcus pneumoniae: non-sterile sites (V2) 9 Streptococcus pneumoniae: sterile sites (V2) 9 Viridans Streptococcus (KB & E-test or Microscan) MIC Enterococcus spp (V2) 6 -strep (GAS, GBS, GCS, GGS) spp: sterile sites (KB) (2) S.agalactiae: from OB screens (KB) 0 MIC 8 7

15 Clindamycin Erythromycin Oxacillin Vancomycin Chloramphenicol Cefazolin Penicillin Ceftriaxone Moxifloxacin Tetracycline Ampicillin Linezolid SXT Levofloxacin Gent Synergy Cascade Reporting: GPC Non-urine/Non-CSF Staphylococcus species (V2) R 2, 5 Streptococcus pneumoniae: non-sterile sites (V2) 9 Streptococcus pneumoniae: sterile sites (V2) 9 Viridans Streptococcus (KB & E-test or Microscan) MIC Enterococcus spp (V2) 6 -strep (GAS, GBS, GCS, GGS) spp: sterile sites (KB) (2) S.agalactiae: from OB screens (KB) 0 MIC 8 7 R Routinely reported. Always report as resistant. If SDD, I or R, report antimicrobials touching arrowhead

16 Clindamycin Erythromycin Oxacillin Vancomycin Chloramphenicol Cefazolin Penicillin Ceftriaxone Moxifloxacin Tetracycline Ampicillin Linezolid SXT Levofloxacin Gent Synergy Cascade Reporting: GPC Non-urine/Non-CSF Staphylococcus species (V2) R 2, 5 Streptococcus pneumoniae: non-sterile sites (V2) 9 Streptococcus pneumoniae: sterile sites (V2) 9 Viridans Streptococcus (KB & E-test or Microscan) MIC Enterococcus spp (V2) 6 -strep (GAS, GBS, GCS, GGS) spp: sterile sites (KB) (2) S.agalactiae: from OB screens (KB) Perform D-test; Report Clinda-R if D-test positive. 2 If S. aureus and vanco MIC = 2, add comment code VANCO2 : Vancomycin MIC = 2 µg/ml. For isolates with a vancomycin minimum inhibitory concentration (MIC) of 2, the patient s clinical response should determine the continued use of vancomycin, independent of the MIC. 0 MIC 8 7

17 Clindamycin Erythromycin Oxacillin Vancomycin Chloramphenicol Cefazolin Penicillin Ceftriaxone Moxifloxacin Tetracycline Ampicillin Linezolid SXT Levofloxacin Gent Synergy Cascade Reporting: GPC Non-urine/Non-CSF Staphylococcus species (V2) R 2, 5 Streptococcus pneumoniae: non-sterile sites (V2) 9 Streptococcus pneumoniae: sterile sites (V2) 9 Viridans Streptococcus (KB & E-test or Microscan) MIC Enterococcus spp (V2) 6 -strep (GAS, GBS, GCS, GGS) spp: sterile sites (KB) (2) S.agalactiae: from OB screens (KB) 0 MIC 8 7 CF (Cystic Fibrosis) isolates only If MRSA, report chloramphenicol and linezolid. Report Cefazolin as resistant if Oxacillin is resistant. 5 If testing manually, use E-test (not KB).

18 Clindamycin Erythromycin Oxacillin Vancomycin Chloramphenicol Cefazolin Penicillin Ceftriaxone Moxifloxacin Tetracycline Ampicillin Linezolid SXT Levofloxacin Gent Synergy Cascade Reporting: GPC Non-urine/Non-CSF Staphylococcus species (V2) R 2, 5 Streptococcus pneumoniae: non-sterile sites (V2) 9 Streptococcus pneumoniae: sterile sites (V2) 9 Viridans Streptococcus (KB & E-test or Microscan) MIC Enterococcus spp (V2) 6 -strep (GAS, GBS, GCS, GGS) spp: sterile sites (KB) (2) S.agalactiae: from OB screens (KB) 6 If vancomycin-r E.casseliflavus or E.gallinarum, add comment NOTVRE to report. 7 Report Gentamicin synergy only for Blood isolates; Report as resistant when Ampicillin resistant & Vancomycin resistant regardless of test result. 8 Report only on VRE. 0 MIC 8 7

19 Clindamycin Erythromycin Oxacillin Vancomycin Chloramphenicol Cefazolin Penicillin Ceftriaxone Moxifloxacin Tetracycline Ampicillin Linezolid SXT Levofloxacin Gent Synergy Cascade Reporting: GPC Non-urine/Non-CSF Staphylococcus species (V2) R 2, 5 Streptococcus pneumoniae: non-sterile sites (V2) 9 Streptococcus pneumoniae: sterile sites (V2) 9 Viridans Streptococcus (KB & E-test or Microscan) MIC Enterococcus spp (V2) 6 -strep (GAS, GBS, GCS, GGS) spp: sterile sites (KB) (2) S.agalactiae: from OB screens (KB) 0 MIC Transcribe the Penicillin MIC result into both the Pen IV and Pen oral MIC fields in the LIS. 0 Do not report but add comment BETAS to report ( Beta-hemolytic streptococci are routinely susceptible to penicillins and cephalosporins. ) Report CTX (meningitis) and CTX (non-meningitis) results.

20 Clindamycin Erythromycin Oxacillin Vancomycin Chloramphenicol Cefazolin Penicillin Ceftriaxone Moxifloxacin Tetracycline Ampicillin Linezolid SXT Levofloxacin Gent Synergy Cascade Reporting: GPC Non-urine/Non-CSF Staphylococcus species (V2) R 2, 5 Streptococcus pneumoniae: non-sterile sites (V2) 9 Streptococcus pneumoniae: sterile sites (V2) 9 Viridans Streptococcus (KB & E-test or Microscan) MIC Enterococcus spp (V2) 6 -strep (GAS, GBS, GCS, GGS) spp: sterile sites (KB) (2) S.agalactiae: from OB screens (KB) 0 MIC For -hemolytic viridans strep (i.e., S.anginosis group) use the Viridans Streptococcus cascade. Report for S.aureus only. If Penicillin-S and Ceftriaxone-NS, restest and bring to rounds.

21 Oxacillin Vancomycin Cefazolin Penicillin Tetracycline Ampicillin Ciprofloxacin Nitrofurantoin Linezolid SXT Cascade Reporting: GPC Urine V2 Staphylococcus spp, 5 2 R 6 Enterococcus spp R Routinely reported. Always report as resistant.

22 Oxacillin Vancomycin Cefazolin Penicillin Tetracycline Ampicillin Ciprofloxacin Nitrofurantoin Linezolid SXT Cascade Reporting: GPC Urine V2 Staphylococcus spp, 5 2 R 6 Enterococcus spp If S. aureus and vanco MIC = 2, add comment code VANCO2 : Vancomycin MIC = 2 µg/ml. For isolates with a vancomycin minimum inhibitory concentration (MIC) of 2, the patient s clinical response should determine the continued use of vancomycin, independent of the MIC. 2 Report Cefazolin as R if Oxacillin is R, and report Cefazolin as S if Oxacillin is S.

23 Oxacillin Vancomycin Cefazolin Penicillin Tetracycline Ampicillin Ciprofloxacin Nitrofurantoin Linezolid SXT Cascade Reporting: GPC Urine V2 Staphylococcus spp, 5 2 R 6 Enterococcus spp If vancomycin-resistant E.casseliflavus or E.gallinarum, add comment NOTVRE to report. Report only on VRE. 5. If testing manually, use E-test (not KB). 6. Report on S. aureus only.

24 Ampicillin Amox/Clav. Gentamicin Pip/Tazo Tobramycin Cefazolin Ceftriaxone Ertapenem 0 & Trimeth/Sulfa Ciprofloxacin Nalidixic Acid Cascade Reporting: Enterobacteriaceae non-csf V2 Amikacin Nitrofurantoin 2 Tetracycline 2 Ceftazidime 7 Cefepime 5 Meropenem 0 E. coli Pantoea spp. P. mirabilis Klebsiella spp Citrobacter koseri Citrobacter spp (except C. koseri) Enterobacter spp Hafnia alveii Serratia spp Morganella morganii Proteus vulgaris/penneri Providencia spp Salmonella spp Shigella spp n/a 9 R R R R R R R R R R 6 R R R R R R R 8 8

25 Ampicillin Amox/Clav. Gentamicin Pip/Tazo Tobramycin Cefazolin Ceftriaxone Ertapenem 0 & Trimeth/Sulfa Ciprofloxacin Nalidixic Acid Cascade Reporting: Enterobacteriaceae non-csf V2 Amikacin Nitrofurantoin 2 Tetracycline 2 Ceftazidime 7 Cefepime 5 Meropenem 0 E. coli Pantoea spp. P. mirabilis Klebsiella spp Citrobacter koseri Citrobacter spp (except C. koseri) Enterobacter spp Hafnia alveii Serratia spp Morganella morganii Proteus vulgaris/penneri Providencia spp Salmonella spp Shigella spp n/a 9 R R R R R R R R R R 6 R R R R R R R 8 8 R Routinely reported. Always report as resistant. If SDD, I or R, report antimicrobials touching arrowhead.

26 Ampicillin Amox/Clav. Gentamicin Pip/Tazo Tobramycin Cefazolin Ceftriaxone Ertapenem 0 & Trimeth/Sulfa Ciprofloxacin Nalidixic Acid Cascade Reporting: Enterobacteriaceae non-csf V2 Amikacin Nitrofurantoin 2 Tetracycline 2 Ceftazidime 7 Cefepime 5 Meropenem 0 E. coli Pantoea spp. P. mirabilis Klebsiella spp Citrobacter koseri Citrobacter spp (except C. koseri) Enterobacter spp Hafnia alveii Serratia spp Morganella morganii Proteus vulgaris/penneri Providencia spp Salmonella spp Shigella spp n/a 9 R R R R R R R R R R 6 R R R R R R R 8 8 For Cipro susceptible Salmonella, test Nalidixic acid by KB. If Nalidixic Acid is S, report the Ciprofloxacin result. If Nalidixic Acid is I or R, report Ciprofloxacin and Nalidixic Acid and add the following comment to report: ( SALMFQ ) = Fluoroquinolone-susceptible strains of Salmonella that test non-susceptible to nalidixic acid may be associated with clinical failure or delayed response in fluoroquinolone-treated patients with extra intestinal salmonellosis. A consultation with an infectious disease practitioner is recommended.

27 Ampicillin Amox/Clav. Gentamicin Pip/Tazo Tobramycin Cefazolin Ceftriaxone Ertapenem 0 & Trimeth/Sulfa Ciprofloxacin Nalidixic Acid Cascade Reporting: Enterobacteriaceae non-csf V2 Amikacin Nitrofurantoin 2 Tetracycline 2 Ceftazidime 7 Cefepime 5 Meropenem 0 E. coli Pantoea spp. P. mirabilis Klebsiella spp Citrobacter koseri Citrobacter spp (except C. koseri) Enterobacter spp Hafnia alveii Serratia spp Morganella morganii Proteus vulgaris/penneri Providencia spp Salmonella spp Shigella spp n/a 9 R R R R R R R R R R 6 R R R R R R R Report only for urinary isolates. If Vitek result is I or R, perform an alternate method of testing due to Vitek limitation. If Ceftriaxone is S, I or R and Ceftazidime and/or Cefipime is non-s (SDD, I or R), then report Ceftriaxone, Ceftazidime, and Cefepime.

28 Ampicillin Amox/Clav. Gentamicin Pip/Tazo Tobramycin Cefazolin Ceftriaxone Ertapenem 0 & Trimeth/Sulfa Ciprofloxacin Nalidixic Acid Cascade Reporting: Enterobacteriaceae non-csf V2 Amikacin Nitrofurantoin 2 Tetracycline 2 Ceftazidime 7 Cefepime 5 Meropenem 0 E. coli Pantoea spp. P. mirabilis Klebsiella spp Citrobacter koseri Citrobacter spp (except C. koseri) Enterobacter spp Hafnia alveii Serratia spp Morganella morganii Proteus vulgaris/penneri Providencia spp Salmonella spp Shigella spp n/a 9 R R R R R R R R R R 6 R R R R R R R Only if Cefepime is non-s, continue cascade and report Ertapenem and Meropenem. 6 Perform an alternate method of testing for Pip/Tazo vs. Serratia marcescens due to a Vitek limitation. 7 If Ceftazidime is non-s or if Vitek flags the isolate as an ESBL, result the ESBL biochemical as Yes for E.coli, Klebsiella spp and P.mirabilis.

29 Ampicillin Amox/Clav. Gentamicin Pip/Tazo Tobramycin Cefazolin Ceftriaxone Ertapenem 0 & Trimeth/Sulfa Ciprofloxacin Nalidixic Acid Cascade Reporting: Enterobacteriaceae non-csf V2 Amikacin Nitrofurantoin 2 Tetracycline 2 Ceftazidime 7 Cefepime 5 Meropenem 0 E. coli Pantoea spp. P. mirabilis Klebsiella spp Citrobacter koseri Citrobacter spp (except C. koseri) Enterobacter spp Hafnia alveii Serratia spp Morganella morganii Proteus vulgaris/penneri Providencia spp Salmonella spp Shigella spp n/a 9 R R R R R R R R R R 6 R R R R R R R If Ceftriaxone is non-susceptible, confirm results. Bring to rounds if non-susceptibility is confirmed. 9 Due to a Vitek limitation, Ampicillin is not routinely reported for Pantoea spp. If Ampicillin is requested, test by KB and cascade to Amox/Clav if Ampicillin is resistant.

30 Ampicillin Amox/Clav. Gentamicin Pip/Tazo Tobramycin Cefazolin Ceftriaxone Ertapenem 0 & Trimeth/Sulfa Ciprofloxacin Nalidixic Acid Cascade Reporting: Enterobacteriaceae non-csf V2 Amikacin Nitrofurantoin 2 Tetracycline 2 Ceftazidime 7 Cefepime 5 Meropenem 0 E. coli Pantoea spp. P. mirabilis Klebsiella spp Citrobacter koseri Citrobacter spp (except C. koseri) Enterobacter spp Hafnia alveii Serratia spp Morganella morganii Proteus vulgaris/penneri Providencia spp Salmonella spp Shigella spp n/a 9 R R R R R R R R R R 6 R R R R R R R Even if not cascaded, if Ertapenem and/or Meropenem are non-susceptible, confirm by disk diffusion, including Imipenem. If non-susceptibility is confirmed, report Ertapenem, Meropenem and Imipenem and refer to Attachment 8 to see if the isolate meets the case definition for CRE.

31 Ampicillin Amox/Clav. Gentamicin Pip/Tazo Tobramycin Cefazolin Ceftriaxone Ertapenem 0 & Trimeth/Sulfa Ciprofloxacin Nalidixic Acid Cascade Reporting: Enterobacteriaceae non-csf V2 Amikacin Nitrofurantoin 2 Tetracycline 2 Ceftazidime 7 Cefepime 5 Meropenem 0 E. coli Pantoea spp. P. mirabilis Klebsiella spp Citrobacter koseri Citrobacter spp (except C. koseri) Enterobacter spp Hafnia alveii Serratia spp Morganella morganii Proteus vulgaris/penneri Providencia spp Salmonella spp Shigella spp n/a 9 R R R R R R R R R R 6 R R R R R R R 8 8. Even if it is not cascaded, if Amikacin is non-susceptible, report Gentamycin, Tobramycin and Amikacin.

32 Ceftriaxone ( rd gen) Gentamicin Tobramycin Amikacin Trimeth/Sulfa Ciprofloxacin Pip/Tazo Ceftazidime Cefepime Meropenem Levofloxacin Timentin Cascade Reporting: Non-Enterobacteriaceae non-csf V2 Pseudomonas aeruginosa 5 6 Pseudomonas spp () Other non-enteric bacilli () 5 Burkholderia cepacia Stenotrophomonas maltophilia Acinetobacter spp 2 2

33 Ceftriaxone ( rd gen) Gentamicin Tobramycin Amikacin Trimeth/Sulfa Ciprofloxacin Pip/Tazo Ceftazidime Cefepime Meropenem Levofloxacin Timentin Cascade Reporting: Non-Enterobacteriaceae non-csf V2 Pseudomonas aeruginosa 5 6 Pseudomonas spp () Other non-enteric bacilli () 5 Burkholderia cepacia Stenotrophomonas maltophilia Acinetobacter spp 2 2 Routinely reported. If I or R, report antimicrobials touching arrowhead.

34 Ceftriaxone ( rd gen) Gentamicin Tobramycin Amikacin Trimeth/Sulfa Ciprofloxacin Pip/Tazo Ceftazidime Cefepime Meropenem Levofloxacin Timentin Cascade Reporting: Non-Enterobacteriaceae non-csf V2 Pseudomonas aeruginosa 5 6 Pseudomonas spp () Other non-enteric bacilli () 5 Burkholderia cepacia Stenotrophomonas maltophilia Acinetobacter spp 2 2 Perform by manual MIC panel testing. 2 Amikacin must be tested by KB due to a Vitek-2 limitation; if you suspect the ID will be an Acinetobacter spp, set an AMK KB at the same time as you set up the AST panel. Also set PTZ KB as Vitek may not interpret results on Acinetobacter spp. other than A. baumannii. MIC testing only.

35 Ceftriaxone ( rd gen) Gentamicin Tobramycin Amikacin Trimeth/Sulfa Ciprofloxacin Pip/Tazo Ceftazidime Cefepime Meropenem Levofloxacin Timentin Cascade Reporting: Non-Enterobacteriaceae non-csf V2 Pseudomonas aeruginosa 5 6 Pseudomonas spp () Other non-enteric bacilli () 5 Burkholderia cepacia Stenotrophomonas maltophilia Acinetobacter spp 2 2 If Vitek result is resistant perform an alternate method of testing due to a Vitek limitation. 5 Report Amikacin if either Gentamicin or Tobramycin are non-s. 6 If Timentin is requested test by KB (not MIC panel).

36 Ampicillin Ceftriaxone Oxacillin Penicillin SXT Vancomycin Meropenem Cascade Reporting: GPC CSF Gram Positive Staphylococcus spp (V2) Streptococcus pneumoniae (V2) Viridans Streptococcus E-test E-test Enterococcus spp (V2), 2 Routinely reported. If Vancomycin MIC is > 2 for S. aureus, set up E-test for Vancomycin and bring to rounds if E-test MIC is > 2. If vanco MIC = 2, add comment code VANCO2 = Vancomycin MIC = 2 µg/ml. For isolates with a vancomycin minimum inhibitory concentration (MIC) of 2, the patient s clinical response should determine the continued use of vancomycin, independent of the MIC. 2 If testing manually, use E-test. Report CTX (meningitis) only and Penicillin (IV) only.

37 Amikacin Ampicillin Amox/Clav Ceftriaxone Ceftazidime Cefepime Gentamicin Pip/Tazo Meropenem Ertapenem SXT Tobramycin Cascade Reporting: GNR CSF Gram Negative E. coli (V2) P. Mirabilis Salmonella spp (V2) Shigella spp 2 All other enteric GNRs (V2) Non-enterics (V2) (non-fermenters) Routinely reported. If I or R, report antimicrobials touching arrowhead.. For E. coli, Klebsiella spp., and P. mirabilis: If Ceftazidime is non-s or if Vitek flags the isolate as ESBL, result ESBL biochem as Yes. 2. If Ceftriaxone is non-susceptible, confirm results. Bring to rounds if non-susceptibility is confirmed.. Even if not cascaded, if Ertapenem and/or Meropenem are confirmed as non-susceptible, report both.

38 Cascade Reporting SUMMARY: Use the CLSI M00 document as a guide. Decide with your ID, ID pharmacy, and IC clinicians what should be reported for your organism groups. What is routinely reported What is cascaded What is tested/reported only by special request Have clear guidance/training for your staff.

39 EXERCISE Develop a cascade reporting document (with footnotes!) for an inpatient population for the enterobacteriaceae using the CLSI M00-S2 along with the following directions from your Infectious Disease team: First line aminoglycoside is tobramycin Piperacillin/tazobactam reported out on all GNRs Cefepime should be reserved for resistant organisms Carbapenem of choice is imipenem, but should be reserved for resistant organisms Levofloxacin is used primarily, not ciprofloxacin Cefotaxime is the primary rd generation cephalosporin Include any special considerations for UTI organisms

40 DRUGS GN BUGs

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine 2012 ANTIBIOGRAM Central Zone Former DTHR Sites Department of Pathology and Laboratory Medicine Medically Relevant Pathogens Based on Gram Morphology Gram-negative Bacilli Lactose Fermenters Non-lactose

More information

2015 Antibiotic Susceptibility Report

2015 Antibiotic Susceptibility Report Citrobacter freundii Enterobacter aerogenes Enterobacter cloacae Escherichia coli Haemophilus influenzenza Klebsiella oxytoca Klebsiella pneumoniae Proteus mirabilis Pseudomonas aeruginosa Serratia marcescens

More information

2016 Antibiotic Susceptibility Report

2016 Antibiotic Susceptibility Report Fairview Northland Medical Center and Elk River, Milaca, Princeton and Zimmerman Clinics 2016 Antibiotic Susceptibility Report GRAM-NEGATIVE ORGANISMS 2016 Gram-Negative Non-Urine The number of isolates

More information

Antimicrobial Susceptibility Testing: The Basics

Antimicrobial Susceptibility Testing: The Basics Antimicrobial Susceptibility Testing: The Basics Susan E. Sharp, Ph.D., DABMM, FAAM Director, Airport Way Regional Laboratory Director, Regional Microbiology and Molecular Infectious Diseases Laboratories

More information

Mercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016

Mercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016 Mercy Medical Center Des Moines, Iowa Department of Pathology Microbiology Department Antibiotic Susceptibility January December 2016 These statistics are intended solely as a GUIDE to choosing appropriate

More information

Concise Antibiogram Toolkit Background

Concise Antibiogram Toolkit Background Background This toolkit is designed to guide nursing homes in creating their own antibiograms, an important tool for guiding empiric antimicrobial therapy. Information about antibiograms and instructions

More information

CONTAGIOUS COMMENTS Department of Epidemiology

CONTAGIOUS COMMENTS Department of Epidemiology VOLUME XXIX NUMBER 3 November 2014 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine Dowell SM MLS (ASCP), Marti Roe SM MLS (ASCP), Sarah Parker MD, Jason Child PharmD, and Samuel R.

More information

2010 ANTIBIOGRAM. University of Alberta Hospital and the Stollery Children s Hospital

2010 ANTIBIOGRAM. University of Alberta Hospital and the Stollery Children s Hospital 2010 ANTIBIOGRAM University of Alberta Hospital and the Stollery Children s Hospital Medical Microbiology Department of Laboratory Medicine and Pathology Table of Contents Page Introduction..... 2 Antibiogram

More information

Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing

Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing These suggestions are intended to indicate minimum sets of agents to test routinely in a diagnostic laboratory

More information

2017 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose

2017 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose 2017 Antibiogram Central Zone Alberta Health Services including Red Deer Regional Hospital St. Mary s Hospital, Camrose Introduction This antibiogram is a cumulative report of the antimicrobial susceptibility

More information

a. 379 laboratories provided quantitative results, e.g (DD method) to 35.4% (MIC method) of all participants; see Table 2.

a. 379 laboratories provided quantitative results, e.g (DD method) to 35.4% (MIC method) of all participants; see Table 2. AND QUANTITATIVE PRECISION (SAMPLE UR-01, 2017) Background and Plan of Analysis Sample UR-01 (2017) was sent to API participants as a simulated urine culture for recognition of a significant pathogen colony

More information

2015 Antibiogram. Red Deer Regional Hospital. Central Zone. Alberta Health Services

2015 Antibiogram. Red Deer Regional Hospital. Central Zone. Alberta Health Services 2015 Antibiogram Red Deer Regional Hospital Central Zone Alberta Health Services Introduction. This antibiogram is a cumulative report of the antimicrobial susceptibility rates of common microbial pathogens

More information

RCH antibiotic susceptibility data

RCH antibiotic susceptibility data RCH antibiotic susceptibility data The following represent RCH antibiotic susceptibility data from 2008. This data is used to inform antibiotic guidelines used at RCH. The data includes all microbiological

More information

EUCAST recommended strains for internal quality control

EUCAST recommended strains for internal quality control EUCAST recommended strains for internal quality control Escherichia coli Pseudomonas aeruginosa Staphylococcus aureus Enterococcus faecalis Streptococcus pneumoniae Haemophilus influenzae ATCC 59 ATCC

More information

جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی

جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی ویرایش دوم بر اساس ed., 2017 CLSI M100 27 th تابستان ۶۹۳۱ تهیه

More information

January 2014 Vol. 34 No. 1

January 2014 Vol. 34 No. 1 January 2014 Vol. 34 No. 1. and Minimal Inhibitory Concentration (MIC) Interpretive Standards for Testing Conditions Medium: diffusion: Mueller-Hinton agar (MHA) roth dilution: cation-adjusted Mueller-Hinton

More information

European Committee on Antimicrobial Susceptibility Testing

European Committee on Antimicrobial Susceptibility Testing European Committee on Antimicrobial Susceptibility Testing Routine and extended internal quality control as recommended by EUCAST Version 5.0, valid from 015-01-09 This document should be cited as "The

More information

European Committee on Antimicrobial Susceptibility Testing

European Committee on Antimicrobial Susceptibility Testing European Committee on Antimicrobial Susceptibility Testing Routine and extended internal quality control for MIC determination and disk diffusion as recommended by EUCAST Version 8.0, valid from 018-01-01

More information

2009 ANTIBIOGRAM. University of Alberta Hospital and the Stollery Childrens Hospital

2009 ANTIBIOGRAM. University of Alberta Hospital and the Stollery Childrens Hospital 2009 ANTIBIOGRAM University of Alberta Hospital and the Stollery Childrens Hospital Division of Medical Microbiology Department of Laboratory Medicine and Pathology 2 Table of Contents Page Introduction.....

More information

Understanding the Hospital Antibiogram

Understanding the Hospital Antibiogram Understanding the Hospital Antibiogram Sharon Erdman, PharmD Clinical Professor Purdue University College of Pharmacy Infectious Diseases Clinical Pharmacist Eskenazi Health 5 Understanding the Hospital

More information

Compliance of manufacturers of AST materials and devices with EUCAST guidelines

Compliance of manufacturers of AST materials and devices with EUCAST guidelines Compliance of manufacturers of AST materials and devices with EUCAST guidelines Data are based on questionnaires to manufacturers of materials and devices for antimicrobial susceptibility testing. The

More information

The Basics: Using CLSI Antimicrobial Susceptibility Testing Standards

The Basics: Using CLSI Antimicrobial Susceptibility Testing Standards The Basics: Using CLSI Antimicrobial Susceptibility Testing Standards Janet A. Hindler, MCLS, MT(ASCP) UCLA Health System Los Angeles, California, USA jhindler@ucla.edu 1 Learning Objectives Describe information

More information

2016 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose

2016 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose 2016 Antibiogram Central Zone Alberta Health Services including Red Deer Regional Hospital St. Mary s Hospital, Camrose Introduction This antibiogram is a cumulative report of the antimicrobial susceptibility

More information

Compliance of manufacturers of AST materials and devices with EUCAST guidelines

Compliance of manufacturers of AST materials and devices with EUCAST guidelines Compliance of manufacturers of AST materials and devices with EUCAST guidelines Data are based on questionnaires to manufacturers of materials and devices for antimicrobial susceptibility testing. The

More information

CONTAGIOUS COMMENTS Department of Epidemiology

CONTAGIOUS COMMENTS Department of Epidemiology VOLUME XXIII NUMBER 1 July 2008 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine Dowell, SM (ASCP), Marti Roe SM (ASCP), Ann-Christine Nyquist MD, MSPH Are the bugs winning? The 2007

More information

BACTERIAL SUSCEPTIBILITY REPORT: 2016 (January 2016 December 2016)

BACTERIAL SUSCEPTIBILITY REPORT: 2016 (January 2016 December 2016) BACTERIAL SUSCEPTIBILITY REPORT: 2016 (January 2016 December 2016) VA Palo Alto Health Care System April 14, 2017 Trisha Nakasone, PharmD, Pharmacy Service Russell Ryono, PharmD, Public Health Surveillance

More information

Antibiotic. Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting

Antibiotic. Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting Antibiotic Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting Any substance of natural, synthetic or semisynthetic origin which at low concentrations kills or inhibits the growth of bacteria

More information

Routine internal quality control as recommended by EUCAST Version 3.1, valid from

Routine internal quality control as recommended by EUCAST Version 3.1, valid from Routine internal quality control as recommended by EUCAST Version.1, valid from 01-01-01 Escherichia coli Pseudomonas aeruginosa Staphylococcus aureus Enterococcus faecalis Streptococcus pneumoniae Haemophilus

More information

What s new in EUCAST methods?

What s new in EUCAST methods? What s new in EUCAST methods? Derek Brown EUCAST Scientific Secretary Interactive question 1 MIC determination MH-F broth for broth microdilution testing of fastidious microorganisms Gradient MIC tests

More information

Antimicrobial susceptibility

Antimicrobial susceptibility Antimicrobial susceptibility PATTERNS Microbiology Department Canterbury ealth Laboratories and Clinical Pharmacology Department Canterbury District ealth Board March 2011 Contents Preface... Page 1 ANTIMICROBIAL

More information

CONTAGIOUS COMMENTS Department of Epidemiology

CONTAGIOUS COMMENTS Department of Epidemiology VOLUME XXXII NUMBER 6 September 2017 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine Dowell SM MLS (ASCP), Stacey Hamilton MT SM (ASCP), Samuel Dominguez MD PhD, Sarah Parker MD, and

More information

Help with moving disc diffusion methods from BSAC to EUCAST. Media BSAC EUCAST

Help with moving disc diffusion methods from BSAC to EUCAST. Media BSAC EUCAST Help with moving disc diffusion methods from BSAC to EUCAST This document sets out the main differences between the BSAC and EUCAST disc diffusion methods with specific emphasis on preparation prior to

More information

INFECTIOUS DISEASES DIAGNOSTIC LABORATORY NEWSLETTER

INFECTIOUS DISEASES DIAGNOSTIC LABORATORY NEWSLETTER INFECTIOUS DISEASES DIAGNOSTIC LABORATORY NEWSLETTER University of Minnesota Health University of Minnesota Medical Center University of Minnesota Masonic Children s Hospital May 2017 Printed herein are

More information

Aberdeen Hospital. Antibiotic Susceptibility Patterns For Commonly Isolated Organisms For 2015

Aberdeen Hospital. Antibiotic Susceptibility Patterns For Commonly Isolated Organisms For 2015 Aberdeen Hospital Antibiotic Susceptibility Patterns For Commonly Isolated s For 2015 Services Laboratory Microbiology Department Aberdeen Hospital Nova Scotia Health Authority 835 East River Road New

More information

THE NAC CHALLENGE PANEL OF ISOLATES FOR VERIFICATION OF ANTIBIOTIC SUSCEPTIBILITY TESTING METHODS

THE NAC CHALLENGE PANEL OF ISOLATES FOR VERIFICATION OF ANTIBIOTIC SUSCEPTIBILITY TESTING METHODS THE NAC CHALLENGE PANEL OF ISOLATES FOR VERIFICATION OF ANTIBIOTIC SUSCEPTIBILITY TESTING METHODS Stefanie Desmet University Hospitals Leuven Laboratory medicine microbiology stefanie.desmet@uzleuven.be

More information

TABLE OF CONTENTS. Urine - Gram Positive Susceptibility Reporting 1 Staphylococcus species, MRSA...11

TABLE OF CONTENTS. Urine - Gram Positive Susceptibility Reporting 1 Staphylococcus species, MRSA...11 Policy #MI\ANTI\v23 Page 1 of 3 Section: Antimicrobial Susceptibility Testing Subject Title: Table of Contents Manual Issued by: LABORATORY MANAGER Original Date: January 10, 2000 Approved by: Laboratory

More information

Intrinsic, implied and default resistance

Intrinsic, implied and default resistance Appendix A Intrinsic, implied and default resistance Magiorakos et al. [1] and CLSI [2] are our primary sources of information on intrinsic resistance. Sanford et al. [3] and Gilbert et al. [4] have been

More information

21 st Expert Committee on Selection and Use of Essential Medicines Peer Review Report Antibiotics Review

21 st Expert Committee on Selection and Use of Essential Medicines Peer Review Report Antibiotics Review (1) Have all important studies/evidence of which you are aware been included in the application? Yes No Please provide brief comments on any relevant studies that have not been included: (2) For each of

More information

GENERAL NOTES: 2016 site of infection type of organism location of the patient

GENERAL NOTES: 2016 site of infection type of organism location of the patient GENERAL NOTES: This is a summary of the antibiotic sensitivity profile of clinical isolates recovered at AIIMS Bhopal Hospital during the year 2016. However, for organisms in which < 30 isolates were recovered

More information

Table 1. Commonly encountered or important organisms and their usual antimicrobial susceptibilities.

Table 1. Commonly encountered or important organisms and their usual antimicrobial susceptibilities. Table 1. Commonly encountered or important organisms and their usual antimicrobial susceptibilities. Gram-positive cocci: Staphylococcus aureus: *Resistance to penicillin is almost universal. Resistance

More information

January 2014 Vol. 34 No. 1

January 2014 Vol. 34 No. 1 January 2014 Vol. 34 No. 1. and Minimum Inhibitory Concentration (MIC) Interpretive Standards for Testing Conditions Medium: diffusion: Mueller-Hinton agar (MHA) Broth dilution: cation-adjusted Mueller-Hinton

More information

UNDERSTANDING YOUR DATA: THE ANTIBIOGRAM

UNDERSTANDING YOUR DATA: THE ANTIBIOGRAM UNDERSTANDING YOUR DATA: THE ANTIBIOGRAM April Abbott, PhD, D(ABMM) Deaconess Health System Evansville, IN April.Abbott@Deaconess.com Special thanks to Dr. Shelley Miller for UCLA data WHAT WE WILL COVER

More information

The β- Lactam Antibiotics. Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018

The β- Lactam Antibiotics. Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018 The β- Lactam Antibiotics Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018 Penicillins. Cephalosporins. Carbapenems. Monobactams. The β- Lactam Antibiotics 2 3 How

More information

Performance Information. Vet use only

Performance Information. Vet use only Performance Information Vet use only Performance of plates read manually was measured in three sites. Each centre tested Enterobacteriaceae, streptococci, staphylococci and pseudomonas-like organisms.

More information

SMART WORKFLOW SOLUTIONS Introducing DxM MicroScan WalkAway System* ...

SMART WORKFLOW SOLUTIONS Introducing DxM MicroScan WalkAway System* ... SMART WORKFLOW SOLUTIONS Introducing DxM MicroScan WalkAway System* The next-generation MicroScan WalkAway System combines proven technology and reliability with enhanced ease-of-use features to streamline

More information

C&W Three-Year Cumulative Antibiogram January 2013 December 2015

C&W Three-Year Cumulative Antibiogram January 2013 December 2015 C&W Three-Year Cumulative Antibiogram January 213 December 215 Division of Microbiology, Virology & Infection Control Department of Pathology & Laboratory Medicine Contents Comments and Limitations...

More information

Antimicrobial Susceptibility Summary 2011

Antimicrobial Susceptibility Summary 2011 Antimicrobial Susceptibility Summary 2011 Clinical Microbiology Department of Pathology & Laboratory Medicine 45 Antimicrobial Susceptibility Summary Clinical Microbiology Department of Pathology and Laboratory

More information

National Clinical Guideline Centre Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults

National Clinical Guideline Centre Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults National Clinical Guideline Centre Antibiotic classifications Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults Clinical guideline 191 Appendix N 3 December 2014

More information

Educating Clinical and Public Health Laboratories About Antimicrobial Resistance Challenges

Educating Clinical and Public Health Laboratories About Antimicrobial Resistance Challenges Educating Clinical and Public Health Laboratories About Antimicrobial Resistance Challenges Janet Hindler, MCLS MT(ASCP) UCLA Medical Center jhindler@ucla.edu also working as a consultant with the Association

More information

Approach to pediatric Antibiotics

Approach to pediatric Antibiotics Approach to pediatric Antibiotics Gassem Gohal FAAP FRCPC Assistant professor of Pediatrics objectives To be familiar with common pediatric antibiotics o Classification o Action o Adverse effect To discus

More information

BactiReg3 Event Notes Module Page(s) 4-9 (TUL) Page 1 of 21

BactiReg3 Event Notes Module Page(s) 4-9 (TUL) Page 1 of 21 www.wslhpt.org 2601 Agriculture Drive Madison, WI 53718 (800) 462-5261 (608) 265-1111 2015-BactiR Reg3 Shipment Date: September 14, 2015 Questions or comments should be directed to Amanda Weiss at 800-462-5261

More information

Antimicrobial Susceptibility Summary 2012

Antimicrobial Susceptibility Summary 2012 Antimicrobial Susceptibility Summary 2012 Clinical Microbiology Department of Pathology & Laboratory Medicine 46 53 Antimicrobial Susceptibility Summary Clinical Microbiology Department of Pathology and

More information

EUCAST-and CLSI potency NEO-SENSITABS

EUCAST-and CLSI potency NEO-SENSITABS EUCASTand CLSI potency NEOSENSITABS Neo Sensitabs Page 1 / 6 Document: 6.2.0 Fastidious organisms EUCAST Interpretation zones and MIC breakpoints according to recommendations by the "Comité de l'antibiogramme

More information

Antimicrobial Susceptibility Patterns

Antimicrobial Susceptibility Patterns Antimicrobial Susceptibility Patterns KNH SURGERY Department Masika M.M. Department of Medical Microbiology, UoN Medicines & Therapeutics Committee, KNH Outline Methodology Overall KNH data Surgery department

More information

microbiology testing services

microbiology testing services microbiology testing services You already know Spectra Laboratories for a wide array of dialysis-related testing services. Now get to know us for your microbiology needs. As the leading provider of renal-specific

More information

QUICK REFERENCE. Pseudomonas aeruginosa. (Pseudomonas sp. Xantomonas maltophilia, Acinetobacter sp. & Flavomonas sp.)

QUICK REFERENCE. Pseudomonas aeruginosa. (Pseudomonas sp. Xantomonas maltophilia, Acinetobacter sp. & Flavomonas sp.) Pseudomonas aeruginosa (Pseudomonas sp. Xantomonas maltophilia, Acinetobacter sp. & Flavomonas sp.) Description: Greenish gray colonies with some beta-hemolysis around each colony on blood agar (BAP),

More information

UNDERSTANDING THE ANTIBIOGRAM

UNDERSTANDING THE ANTIBIOGRAM UNDERSTANDING THE ANTIBIOGRAM April Abbott, PhD, D(ABMM) Deaconess Health System Indiana University School of Medicine - Evansville Evansville, IN April.Abbott@Deaconess.com WHAT WE WILL COVER Describe

More information

2015 Antimicrobial Susceptibility Report

2015 Antimicrobial Susceptibility Report Gram negative Sepsis Outcome Programme (GNSOP) 2015 Antimicrobial Susceptibility Report Prepared by A/Professor Thomas Gottlieb Concord Hospital Sydney Jan Bell The University of Adelaide Adelaide On behalf

More information

Detecting / Reporting Resistance in Nonfastidious GNR Part #2. Janet A. Hindler, MCLS MT(ASCP)

Detecting / Reporting Resistance in Nonfastidious GNR Part #2. Janet A. Hindler, MCLS MT(ASCP) Detecting / Reporting Resistance in Nonfastidious GNR Part #2 Janet A. Hindler, MCLS MT(ASCP) Methods Described in CLSI M100-S21 for Testing non-enterobacteriaceae Organism Disk Diffusion MIC P. aeruginosa

More information

56 Clinical and Laboratory Standards Institute. All rights reserved.

56 Clinical and Laboratory Standards Institute. All rights reserved. Table 2C 56 Clinical and Laboratory Standards Institute. All rights reserved. Table 2C. Zone Diameter and Minimal Inhibitory Concentration Breakpoints for Testing Conditions Medium: Inoculum: diffusion:

More information

Surveillance for Antimicrobial Resistance and Preparation of an Enhanced Antibiogram at the Local Level. janet hindler

Surveillance for Antimicrobial Resistance and Preparation of an Enhanced Antibiogram at the Local Level. janet hindler Surveillance for Antimicrobial Resistance and Preparation of an Enhanced Antibiogram at the Local Level janet hindler At the conclusion of this talk, you will be able to Describe CLSI M39-A3 recommendations

More information

1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient

1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient 1 Chapter 79, Self-Assessment Questions 1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient with normal renal function is: A. Trimethoprim-sulfamethoxazole B. Cefuroxime

More information

Antibiotic Stewardship Program (ASP) CHRISTUS SETX

Antibiotic Stewardship Program (ASP) CHRISTUS SETX Antibiotic Stewardship Program (ASP) CHRISTUS SETX Program Goals I. Judicious use of antibiotics Decrease use of broad spectrum antibiotics and deescalate use based on clinical symptoms Therapeutic duplication:

More information

Leveraging the Lab and Microbiology Department to Optimize Stewardship

Leveraging the Lab and Microbiology Department to Optimize Stewardship Leveraging the Lab and Microbiology Department to Optimize Stewardship Presented by: Andrew Martinez MLS(ASCP), MT(AMT), MBA Alaska Native Medical Center Microbiology Supervisor Maniilaq Health Center

More information

Antibiotic Updates: Part II

Antibiotic Updates: Part II Antibiotic Updates: Part II Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures

More information

ANTIMICROBIAL RELATED LIS CANNED MESSAGES

ANTIMICROBIAL RELATED LIS CANNED MESSAGES Policy # MI\ANTI\04\v01 Page 1 of 5 Section: Antimicrobial Susceptibility Testing Manual Subject Title: Antimicrobial Related LIS Canned Issued by: LABORATORY MANAGER Original Date: November 21, 2005 Approved

More information

Recommendations Regarding Use of Rapid Blood Pathogen Identification Panel Data

Recommendations Regarding Use of Rapid Blood Pathogen Identification Panel Data Recommendations Regarding Use of Rapid Blood Pathogen Identification Panel Data Trevor Van Schooneveld MD, Scott Bergman, PharmD, BCPS, Paul Fey, PhD, Mark Rupp, MD The Clinical Microbiology laboratory

More information

Principles of Antibiotics Use & Spectrum of Some

Principles of Antibiotics Use & Spectrum of Some Principles of Antibiotics Use & Spectrum of Some Rabee Adwan. MD Infectious Diseases Consultant (Pediatric and Adult) Head Of ID Unit and IPAC Committee- AL-Makassed Hospital-AlQuds Head of IPAC Committee

More information

Antibiotic Abyss. Discussion Points. MRSA Treatment Guidelines

Antibiotic Abyss. Discussion Points. MRSA Treatment Guidelines Antibiotic Abyss Fredrick M. Abrahamian, D.O., FACEP, FIDSA Professor of Medicine UCLA School of Medicine Director of Education Department of Emergency Medicine Olive View-UCLA Medical Center Sylmar, California

More information

British Society for Antimicrobial Chemotherapy

British Society for Antimicrobial Chemotherapy British Society for Antimicrobial Chemotherapy BSAC to actively support the EUCAST Disc Diffusion Method for Antimicrobial Susceptibility Testing in preference to the current BSAC Disc Diffusion Method

More information

British Society for Antimicrobial Chemotherapy

British Society for Antimicrobial Chemotherapy British Society for Antimicrobial Chemotherapy Standing Committee on Susceptibility Testing Version 13.0, 10-06-2014 Content Page Additional information Changes in version 13 2 Suggestions for appropriate

More information

5/4/2018. Multidrug Resistant Organisms (MDROs) Objectives. Outline. Define a multi-drug resistant organism (MDRO)

5/4/2018. Multidrug Resistant Organisms (MDROs) Objectives. Outline. Define a multi-drug resistant organism (MDRO) Multidrug Resistant Organisms (MDROs) Kasturi Shrestha, M.D. 05/11/2018 Objectives Define a multi-drug resistant organism (MDRO) Identify most challenging MDROs in healthcare Identify reasons for health

More information

CUMULATIVE ANTIBIOGRAM

CUMULATIVE ANTIBIOGRAM BC Children s Hospital and BC Women s Hospital & Health Centre CUMULATIVE ANTIBIOGRAM 2017 Division of Medical Microbiology Department of Pathology and Laboratory Medicine Page 1 of 5 GRAM-POSITIVE BACTERIA

More information

Update on the CLSI Standards for Antimicrobial Susceptibility Testing: What s New with the Gram Positive Organisms?

Update on the CLSI Standards for Antimicrobial Susceptibility Testing: What s New with the Gram Positive Organisms? 2 0 1 3 CASES (with answers!) Update on the CLSI Standards for Antimicrobial Susceptibility Testing: What s New with the Gram Positive Organisms? Susan E. Sharp, Ph.D., DABMM, FAAM Director - Regional

More information

Bacterial Pathogens in Urinary Tract Infection and Antibiotic Susceptibility Pattern from a Teaching Hospital, Bengaluru, India

Bacterial Pathogens in Urinary Tract Infection and Antibiotic Susceptibility Pattern from a Teaching Hospital, Bengaluru, India ISSN: 2319-7706 Volume 4 Number 11 (2015) pp. 731-736 http://www.ijcmas.com Original Research Article Bacterial Pathogens in Urinary Tract Infection and Antibiotic Susceptibility Pattern from a Teaching

More information

Antimicrobial Resistance Trends in the Province of British Columbia

Antimicrobial Resistance Trends in the Province of British Columbia 655 West 12th Avenue Vancouver, BC V5Z 4R4 Tel 604.707.2443 Fax 604.707.2441 www.bccdc.ca Antimicrobial Resistance Trends in the Province of British Columbia 2013 Prepared by the Do Bugs Need Drugs? Program

More information

EARS Net Report, Quarter

EARS Net Report, Quarter EARS Net Report, Quarter 4 213 March 214 Key Points for 213* Escherichia coli: The proportion of patients with invasive infections caused by E. coli producing extended spectrum β lactamases (ESBLs) increased

More information

Non-Susceptibility of Bacterial Pathogens Causing Hospital-Onset Pneumonia UK and Ireland,

Non-Susceptibility of Bacterial Pathogens Causing Hospital-Onset Pneumonia UK and Ireland, Non-Susceptibility of Bacterial Pathogens Causing Hospital-Onset Pneumonia UK and Ireland, 2008-2016 Alicia Russell Federation of Infection Societies conference 14 th November 2018 alisia_russell BSAC

More information

Antimicrobial Stewardship Strategy: Antibiograms

Antimicrobial Stewardship Strategy: Antibiograms Antimicrobial Stewardship Strategy: Antibiograms A summary of the cumulative susceptibility of bacterial isolates to formulary antibiotics in a given institution or region. Its main functions are to guide

More information

Policy # MI_AST Department of Microbiology. Page Quality Manual

Policy # MI_AST Department of Microbiology. Page Quality Manual Department of Microbiology Version: 2.0 CURRENT 1 of 160 Prepared by QA Committee Issued by: Laboratory Manager Revision Date: 2/26/2018 Approved by Laboratory Director: Annual Review Date: 5/1/2018 Microbiologist-in-Chief

More information

Taiwan Surveillance of Antimicrobial Resistance (TSAR)

Taiwan Surveillance of Antimicrobial Resistance (TSAR) Taiwan Surveillance of Antimicrobial Resistance (TSAR) 2009 MIRL Symposium July 17, 2009 Tsai-Ling Yang Lauderdale ( ) Microbial Infections Reference Laboratory (MIRL) Division of Infectious Diseases,

More information

Interpreting Microbiology reports for better Clinical Decisions Interpreting Antibiogrammes

Interpreting Microbiology reports for better Clinical Decisions Interpreting Antibiogrammes Interpreting Microbiology reports for better Clinical Decisions Interpreting Antibiogrammes Prof C. Wattal Hon. Sr. Consultant & Chairman Dept. of Clinical Microbiology Sir Ganga Ram Hospital New Delhi

More information

AMR Industry Alliance Antibiotic Discharge Targets

AMR Industry Alliance Antibiotic Discharge Targets AMR Industry Alliance Antibiotic Discharge Targets List of Predicted No-Effect Concentrations (PNECs) The members of the AMR Industry Alliance have developed a unified approach to establishing discharge

More information

HUSRES Annual Report 2007 Martti Vaara.

HUSRES Annual Report 2007 Martti Vaara. HUSRES Annual Report 2007 Martti Vaara www.huslab.fi www.intra.hus.fi The basis of this HUSRES 2007 report is the HUSLAB/Whonet database 2007, which contains susceptibility data on about 182.000 bacteria

More information

Available online at ISSN No:

Available online at  ISSN No: Available online at www.ijmrhs.com ISSN No: 2319-5886 International Journal of Medical Research & Health Sciences, 2017, 6(4): 36-42 Comparative Evaluation of In-Vitro Doripenem Susceptibility with Other

More information

BSAC standardized disc susceptibility testing method (version 8)

BSAC standardized disc susceptibility testing method (version 8) Journal of Antimicrobial Chemotherapy (2009) 64, 454 489 doi:10.1093/jac/dkp244 Advance Access publication 8 July 2009 BSAC standardized disc susceptibility testing method (version 8) J. M. Andrews* for

More information

Antimicrobial Agents 101. SWACM 2011 Christopher Doern, Ph.D., D(ABMM)

Antimicrobial Agents 101. SWACM 2011 Christopher Doern, Ph.D., D(ABMM) Antimicrobial Agents 101 SWACM 2011 Christopher Doern, Ph.D., D(ABMM) β -Lactams Penicillins Cephalosporins Carbapenems Monobactams β -Lactamase Inhibitors Clavulanate Amox/Clav Ticar/Clav Sulbactam Amp/Sulb

More information

Childrens Hospital Antibiogram for 2012 (Based on data from 2011)

Childrens Hospital Antibiogram for 2012 (Based on data from 2011) Childrens Hospital Antibiogram for 2012 (Based on data from 2011) Prepared by: Department of Clinical Microbiology, Health Sciences Centre For further information contact: Andrew Walkty, MD, FRCPC Medical

More information

MicroScan Microbiology Systems MORE CHOICES MORE ANSWERS. MicroScan GRAM NEGATIVE AND GRAM POSITIVE PANELS

MicroScan Microbiology Systems MORE CHOICES MORE ANSWERS. MicroScan GRAM NEGATIVE AND GRAM POSITIVE PANELS MicroScan Microbiology Systems MORE CHOICES MORE ANSWERS MicroScan GRAM NEGATIVE AND GRAM POSITIVE PANELS LABORATORIES ON THE FRONT LINE From the National Action Plan for Combating Antibiotic Resistant

More information

A Multi-Laboratory Study of the BIOMIC Automated Well Reading Instrument versus

A Multi-Laboratory Study of the BIOMIC Automated Well Reading Instrument versus JCM Accepts, published online ahead of print on 13 March 2013 J. Clin. Microbiol. doi:10.1128/jcm.03088-12 Copyright 2013, American Society for Microbiology. All Rights Reserved. 1 2 3 A Multi-Laboratory

More information

Infectious Disease: Drug Resistance Pattern in New Mexico

Infectious Disease: Drug Resistance Pattern in New Mexico Infectious Disease: Drug Resistance Pattern in New Mexico Are these the world's sexiest accents? Obi C. Okoli, MD.,MPH. Clinic for Infectious Diseases Las Cruces, NM. Are these the world's sexiest accents?

More information

Michael Hombach*, Guido V. Bloemberg and Erik C. Böttger

Michael Hombach*, Guido V. Bloemberg and Erik C. Böttger J Antimicrob Chemother 2012; 67: 622 632 doi:10.1093/jac/dkr524 Advance Access publication 13 December 2011 Effects of clinical breakpoint changes in CLSI guidelines 2010/2011 and EUCAST guidelines 2011

More information

ESBL Producers An Increasing Problem: An Overview Of An Underrated Threat

ESBL Producers An Increasing Problem: An Overview Of An Underrated Threat ESBL Producers An Increasing Problem: An Overview Of An Underrated Threat Hicham Ezzat Professor of Microbiology and Immunology Cairo University Introduction 1 Since the 1980s there have been dramatic

More information

Dr Neeraj Goel Sr. Consultant Department of Clinical Microbiology. Sir Ganga Ram Hospital

Dr Neeraj Goel Sr. Consultant Department of Clinical Microbiology. Sir Ganga Ram Hospital Dr Neeraj Goel Sr. Consultant Department of Clinical Microbiology Sir Ganga Ram Hospital Resistance profile of MDROs in ICU: Quinolone: 80% Amikacin: 75% Cefaperazone sulbactum: 79% Carbapenems: 79% Super

More information

Interactive session: adapting to antibiogram. Thong Phe Heng Vengchhun Felix Leclerc Erika Vlieghe

Interactive session: adapting to antibiogram. Thong Phe Heng Vengchhun Felix Leclerc Erika Vlieghe Interactive session: adapting to antibiogram Thong Phe Heng Vengchhun Felix Leclerc Erika Vlieghe Case 1 63 y old woman Dx: urosepsis? After 2 d: intermediate result: Gram-negative bacilli Empiric antibiotic

More information

Perichondritis: Source: UpToDate Ciprofloxacin 10 mg/kg/dose PO (max 500 mg/dose) BID Inpatient: Ceftazidime 50 mg/kg/dose q8 hours IV

Perichondritis: Source: UpToDate Ciprofloxacin 10 mg/kg/dose PO (max 500 mg/dose) BID Inpatient: Ceftazidime 50 mg/kg/dose q8 hours IV Empiric Antibiotics for Pediatric Infections Seen in ED NOTE: Choice of empiric antibiotic therapy must take into account local pathogen frequency and resistance patterns, individual patient characteristics,

More information

Einheit für pädiatrische Infektiologie Antibiotics - what, why, when and how?

Einheit für pädiatrische Infektiologie Antibiotics - what, why, when and how? Einheit für pädiatrische Infektiologie Antibiotics - what, why, when and how? Andrea Duppenthaler andrea.duppenthaler@insel.ch Limping patient local pain swelling tenderness warmth fever acute Osteomyelitis

More information

Principles of Infectious Disease. Dr. Ezra Levy CSUHS PA Program

Principles of Infectious Disease. Dr. Ezra Levy CSUHS PA Program Principles of Infectious Disease Dr. Ezra Levy CSUHS PA Program I. Microbiology (1) morphology (e.g., cocci, bacilli) (2) growth characteristics (e.g., aerobic vs anaerobic) (3) other qualities (e.g.,

More information

Recommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland

Recommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland Recommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland A report by the Hospital Antimicrobial Stewardship Working Group, a subgroup of the

More information

ANTIMICROBIAL RESISTANCE SURVEILLANCE FROM SENTINEL PUBLIC HOSPITALS, SOUTH AFRICA, 2014

ANTIMICROBIAL RESISTANCE SURVEILLANCE FROM SENTINEL PUBLIC HOSPITALS, SOUTH AFRICA, 2014 ANTIMICROBIAL RESISTANCE SURVEILLANCE FROM SENTINEL PUBLIC HOSPITALS, SOUTH AFRICA, 2014 Olga Perovic, 1,2 Verushka Chetty 1 & Samantha Iyaloo 1 1 National Institute for Communicable Diseases, NHLS 2 Department

More information