2015 Antibiotic Susceptibility Report
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1 Citrobacter freundii Enterobacter aerogenes Enterobacter cloacae Escherichia coli Haemophilus influenzenza Klebsiella oxytoca Klebsiella pneumoniae Proteus mirabilis Pseudomonas aeruginosa Serratia marcescens Stenotrophomonas Fairview Lakes Medical Center 2015 Antibiotic Susceptibility Report GRAM-NEGATIVE ORGANISMS 2015 Gram-Negative Non-Urine The number of isolates is listed along with the percent of susceptible strains. No. Isolates Amikacin Amoxicillin/Clav (Augmentin) IR IR IR 95 IR IR Ampicillin IR IR IR IR IR 82 IR IR Ampicillin/Sulbactam (Unasyn) IR IR IR IR IR Aztreonam * Cefazolin IR IR IR IR IR Cefepime Cefoxitin IR IR IR NT NT NT NT IR IR Ceftazidime - 3rd Generation Ceftriaxone - 3rd Generation IR 96 Ciprofloxacin Gentamicin Levofloxacin Meropenem (Merrem) Piperacillin/Tazo (Zosyn) Ticarcillin/Clav (Timentin) * 25 Tobramycin Trimethoprim/Sulfa (Bactrim) IR NT 97 : Cumulative data for Stenotrophomonas maltophilia is intrinsically resistant to tetracycline, but not to doxycycline, minocycline, or tigecycline. Enterobactoer and Serratia may develop resistance during prolonged therapy with 3rd generation cephalosporins. Isolates that are initially susceptible may become resistant within 3-4 days.. Enterobacteriaceae are intrinsically resistant to clindamycin, daptomycin, fusidic acid, glycopeptides (vancomycin, teicoplanin), linezolid, quinupristin-dalfopristin, rifampin, and macrolides (erythromycin, clarithromycin, and azithromycin). However, there are some exceptions with macrolides (ie, Salmonella and Shigella spp. with azithromycin) Page 1 of 5
2 Citrobacter freundii Enterobacter aerogenes Enterobacter cloacae Escherichia coli Klebsiella oxytoca Klebsiella pneumoniae Morganella morganii Proteus mirabilis Pseudomonas aeruginosa Serratia marcescens Stenotrophomonas GRAM-NEGATIVE ORGANISMS 2015 Gram-Negative Urine The number of isolates is listed along with the percent of susceptible strains. No. Isolates Amikacin * * * * * * * * * * *NT Ampicillin IR IR IR 65 IR IR IR 90 IR IR Ampicillin/Sulbactam (Unasyn) IR IR IR NT 94 IR IR Cefazolin IR IR IR IR 95 IR IR Cefepime *NT Cefoxitin IR IR IR NT IR Ceftazidime - 3rd Generation *NT Ceftriaxone - 3rd Generation IR 96 Ciprofloxacin Gentamicin Levofloxacin 96 *NT *NT *NT Meropenem (Merrem) * * * * * * * * 100 * Nitrofurantoin (Macrobid) IR IR NT IR Piperacillin/Tazo (Zosyn) * Tobramycin Trimethoprim/Sulfa (Bactrim) NT IR *NT 84 : Cumulative data for Cefazolin results predict results for the oral agents cefaclor, cefdinir, cefpodoxime, cefprozil, cefuroxime axetil, cephalexin, and loracarbef when used for therapy of uncomplicated UTIs due to E.coli, K. pneumoniae, and P. mirabilis. Stenotrophomonas maltophilia is intrinsically resistant to tetracycline, but not to doxycycline, minocycline, or tigecycline. Enterobacter and Serratia may develop resistance during prolonged therapy with 3rd generation cephalosporins. Isolates that are initially susceptible may become resistant within 3-4 days. Enterobacteriaceae are intrinsically resistant to clindamycin, daptomycin, fusidic acid, glycopeptides (vancomycin, teicoplanin), linezolid, quinupristin-dalfopristin, rifampin, and macrolides (erythromycin, clarithromycin, and azithromycin). However, there are some exceptions with macrolides (ie, Salmonella and Shigella spp. with azithromycin) Page 2 of 5
3 Enterococcus Species (Group D. Enterococcus) Staph. Aureus, MSSA Staph. Aureus, MRSA Coag. Negative Staph Strep Agalactiae Group B GRAM-POSITIVE ORGANISMS 2015 Gram- Positive Non-Urine The number of isolates is listed along with the percent of susceptible strains. Staph. lugdunensis Strep. Pneumonia Beta-hemolytic Strep (Groups A, C, F, G) No. Isolates Ampicillin 100 NT NT NT NT NT Cefotaxime - 3rd Generation IR NT NT NT NT NT Ceftriaxone - 3rd Generation IR NT NT NT NT Ceftriaxone (mening) 88 Ceftriaxone (nonmen) 96 Ciprofloxacin NT NT NT Meropenem (Merrom) 94 Clindamycin IR Erythromycin IR NT Gentamicin NT NT NT Levofloxacin NT Linezolid NT NT NT Oxacillin NT NT NT NT Penicillin Penicillin (mening) 68 Penicillin (nonmen) 93 Quinupristin / Dalfoprisin (Synercid) NT NT NT Tetracycline NT NT NT Trimethoprim/Sulfa (Bactrim) IR NT NT NT Vancomycin : Cumulative data for : Synercid used for Vancomycin Resistant Enterococcus faecium only intrinsic resistance shown with other Enterococcus species Page 3 of 5
4 Enterococcus faecalis Enterococcus faecium Staph. Aureus, MSSA Staph. Aureus, MRSA Coag. Negative Staph Strep Agalactiae Group B Aerococcus Urinae GRAM-POSITIVE ORGANISMS 2015 Gram-Positive Urine The number of isolates is listed along with the percent of susceptible strains. No. Isolates Ampicillin NT NT NT Ciprofloxacin NT Clindamycin IR IR NT NT NT * Erythromycin IR IR NT NT NT * Rifampicin * NT NT * * * NT Quinupristin / Dalfoprisin (Synercid) * IR NT NT NT NT Moxifloxacin * * * * * NT NT Gentamicin NT Levofloxacin Linezolid * * 100 * * * * Nitrofurantoin (Macrobid) NT Oxacillin NT NT NT Penicillin Tetracycline NT Trimethoprim/Sulfa (Bactrim) IR IR NT NT IR Vancomycin : Cumulative data for : Synercid used for Vancomycin Resistant Enterococcus faecium only intrinsic resistance shown with other Enterococcus species STAPHYLOCOCCUS: PENICILLINASE-LABILE PENICILLINS Penicillin-susceptible staphylococci are also susceptible to other ß-lactam agents with established clinical efficacy for staphylococcal infections. Penicillin-resistant staphylococci are resistant to penicillinase-labile penicillins, including ampicillin, amoxicillin, azlocillin, carbenicillin, mezlocillin, piperacillin, and tiarcillin. PENICILLINASE-STABLE PENICILLINS Oxacillin results can be applied to the other penicillinase-stable penicillins (cloxacillin, dicloxacillin, flucloxacillin, methicillin, and nafcillin). For agents with established clinical efficacy and considering site of infection and appropriate dosing, oxacillin susceptible staphylococci can be considered susceptible to: ß-lactam/ß-lactamase inhibitor combinations (amoxicillin-clavulanate, ampicillin-sulbactam, piperacillin-tazobactam, ticarcillinclavulanate) Oral cephems (cefaclor, cefdinir, cefpodoxime, cefprozil, cefuroxime, loracarbef) Parenteral cephems including cephalosporins I, II, III, and IV (cefamandole, cefazolin, cefepime, cefmatazole, cefonicid, cefoperazone, cefotaxime, cefotetan, ceftizoxime, ceftriaxone, cefuroxime, cephalothin, ceftaroline, moxalactam) Carbapenems (doripenem, ertapenem, imipenem, meropenem) Page 4 of 5
5 Oxacillin-resistant staphylococci are resistant to all currently available B-lactam antimicrobial agents, with the exception of the newer cephalosporins with anti-mrsa activity. Thus, susceptibility or resistance to a wide array of B-lactam antimicrobial agents may be deduced from testing only penicillin and oxacillin. Routine testing of other B-lactam agents, except those with anti-mrsa activity, is not advised. ENTEROCOCCUS: The results of ampicillin susceptibility tests should be used to predict the activity of amoxicillin. Ampicillin results may be used to predict susceptibility to amoxicillin clavulanate, ampicillin-sulbactam, pipercillin, and piperacillin-tazobactam among non-b-lactamase producing enterococci. Ampicillin susceptibility can be used to predict imipenem susceptibility, providing the species is confirmed to be E. faecalis. Enterococci susceptible to penicillin are predictably susceptible to ampicillin, amoxicillin, ampicillin-sulbactam, amoxicillin-clavulanate, pipercillin and piperacillin-tazobactam for non-b-lactamase-producing entercocci. However, enterococci susceptible to ampicillin cannot be assumed to be susceptible to penicillin. If penicillin results are needed, testing of penicillin is required. FLUOROQUINOLONES Enterococcus spp. and Staphylococcus spp. May develop resistance during prolonged therapy with quinolones. Therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. Testing of repeat isolates may be warranted. TETRACYCLINES that are susceptible to tetracycline are also considered susceptible to doxycycline and minocycline. However, some organisms that are intermediate or resistant to tetracycline may be susceptible to doxcycline, minocycline, or both. Reviewed: Helen Brenny, Director of Laboratory Operations 5/2016 Page 5 of 5
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