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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
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: 1. https://www.safetyadquality.gov.au/our-work/safety-i-e-health/ 2. http://www.eucast.org/cliical_breakpoits/ 3. http://www.eucast.org/expert_rules_ad_itrisic_resistace/ 4. Cliical ad Laboratory Stadards Istitute (CLSI). Guidelie for Aalysis ad Presetatio of Cumulative Atimicrobial Susceptibility (M39-A4). 3rd ed. Pesylvaia: CLSI, 2014 5. www.sp.com.au Page: 3
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 8408 100 Escherichia spp 4001 47.6 Eterococcus spp 1416 16.8 Klebsiella spp 845 10.0 Pseudomoas aerugiosa 641 7.6 Proteus mirabilis 328 3.9 Eterobacter cloacae complex ß haemolytic Streptococci Group B Coagulase egative Staphylococci Citrobacter koseri, amaloaticus group 234 2.8 125 1.5 113 1.3 111 1.3 Klebsiella aerogees 110 1.3 % 54 83 94 87 91 100 94 99 75 99 86 100 3998 4000 3878 3995 3903 *2617 3906 *2634 4001 4001 4000 *389 % 89 R 91 82 21 79 17 97 1414 1416 1416 *1263 *1315 *1317 *1333 % R 93 89 90 94 99 98 100 86 83 90 845 823 843 828 *485 828 *489 845 845 845 % R R 94 R R 95 95 97 95 R R 95 95 641 640 *425 641 *429 *605 638 % 88 95 100 96 99 100 96 100 85 R 97 328 328 318 328 319 *208 319 *212 328 328 % R R 64 R 65 94 91 98 81 81 88 230 233 *178 233 *179 233 234 234 % 100 92 100 72 125 125 124 *98 % 21 61 R 51 98 81 64 91 100 112 113 113 112 113 *22 *22 *23 % R 96 92 91 95 100 100 100 97 97 96 111 109 111 109 *66 109 *66 111 111 111 % R R 76 R 77 99 100 100 94 61 95 109 109 *81 109 *81 110 110 110 Page: 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 8408 100 Staphylococcus aureus (ALL) 89 1.1 Morgaella spp 86 1.0 Serratia spp 83 1.0 Citrobacter freudii complex 61 0.7 Proteus spp other 34 0.4 % 21 79 88 100 85 83 100 100 89 89 85 88 85 *24 *25 *25 % R R 92 R 92 97 93 100 84 R 91 86 86 *66 86 *67 86 86 % R R 98 R 98 100 100 100 90 R 94 83 83 *56 83 *55 83 83 % R R 70 R 67 98 88 96 85 98 89 60 60 *49 60 *49 61 61 61 % R 56 100 R 88 100 97 100 82 R 100 34 34 34 *29 34 *29 34 34 Page: 5
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 3 4.9 Citrobacter koseri, amaloaticus group = 111 Citrobacter koseri 2 1.8 Eterobacter cloacae complex = 234 Eterobacter cloacae 12 5.1 Escherichia spp = 4001 Escherichia coli 304 7.6 Klebsiella aerogees = 110 Eterobacter aerogees 1 0.9 Klebsiella spp = 845 Klebsiella oxytoca 1 0.1 Klebsiella peumoiae 34 4.0 Proteus mirabilis = 328 Proteus mirabilis 1 0.3 Proteus spp other = 34 Proteus peeri 1 2.9 Proteus vulgaris 1 2.9 Urie: Plasmid mediated AMPC producig Eterobacterales (PAMP) Orgaism Name % of Strai Citrobacter koseri, amaloaticus group = 111 Citrobacter koseri 2 1.8 Escherichia spp = 4001 Escherichia coli 146 3.6 Klebsiella spp = 845 Klebsiella oxytoca 2 0.2 Klebsiella peumoiae 13 1.5 Proteus mirabilis = 328 Proteus mirabilis 2 0.6 Raoultella spp = 7 Raoultella orithiolytica 1 14.3 Urie: Plasmid mediated Carbapeemase producig Eterobacterales (CPE) Page: 6
Orgaism Name % of Strai Citrobacter freudii complex = 61 Citrobacter freudii 2 3.3 Eterobacter cloacae complex = 234 Eterobacter cloacae 6 2.6 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 5 0.4 Eterococcus faecium (VRE) - VAN-B 12 0.8 Urie: Methicilli Resistat Staphylococcus aureus (MRSA) Orgaism Name % of Strai Staphylococcus aureus (ALL) = 89 S.aureus (o-multiresistat MRSA) 10 11.2 Staphylococcus aureus (MRSA) 3 3.4 Staphylococcus aureus (UK EMRSA-15) 5 5.6 Page: 7
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 10843 100 Staphylococcus aureus (ALL) Pseudomoas aerugiosa Coagulase egative Staphylococci 3293 30.4 1929 17.8 1150 10.6 Escherichia spp 775 7.1 Haemophilus ifluezae 452 4.2 viridas Streptococci 355 3.3 Eterococcus spp 317 2.9 Klebsiella spp 312 2.9 Eterobacter cloacae complex 259 2.4 % 19 87 87 87 R 97 93 94 100 83 84 95 95 100 3293 3293 3292 3293 3293 3138 3143 3142 3293 3291 3292 *3126 3171 % R R 91 R R 93 96 96 97 97 R 93 1928 1928 1852 1927 1929 *1501 1928 % 15 49 49 49 R 68 81 81 98 50 68 68 100 1140 1134 1134 1134 1142 1101 1120 1119 1139 1136 1141 1132 % 41 74 91 69 81 87 100 90 98 69 82 774 775 774 775 775 770 775 775 *675 775 775 % 60 85 99 69 R R 98 451 452 *68 452 452 % 91 100 85 87 R 100 66 87 72 100 354 *101 *258 *91 *92 352 354 353 *260 % 85 R R R R R R 40 79 R R 32 17 94 317 *103 *140 315 *279 317 % R 89 85 76 89 92 100 98 100 86 89 312 312 312 312 308 312 312 *266 312 312 % R R 67 R 67 85 97 90 98 83 91 255 259 256 259 259 *228 259 259 Page: 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 10843 100 Steotrophomoas maltophilia 141 1.3 Aeromoas spp 127 1.2 ß haemolytic Streptococci Group A 126 1.2 Campylobacter spp 125 1.2 Moraxella catarrhalis 125 1.2 Streptococcus peumoiae 121 1.1 Serratia spp 120 1.1 ß haemolytic Streptococci Other (oa ob) 107 1.0 Spore formig GPB 99 0.9 % R R R R R R 77 R R R 91 R *13 141 % R 41 86 R 95 98 68 100 100 99 99 99 *59 *114 *116 *114 *112 *118 *104 127 *115 *116 % 100 100 99 100 100 97 91 92 83 100 126 125 *83 *15 126 *30 126 126 126 *85 % 86 98 98 90 125 125 124 123 % 0 100 83 99 100 125 125 125 124 125 % 55 80 69 100 73 78 69 100 120 *93 119 *26 121 116 121 *88 % R R 99 R 99 99 99 98 99 99 97 120 120 119 120 120 *108 120 120 % 100 100 100 100 100 100 81 82 64 100 107 103 *71 *25 107 *27 107 107 107 *73 % 14 65 90 98 78 53 84 98 96 *17 *48 *56 *46 95 *91 *89 Page: 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 10843 100 No fermetig GNB 77 0.7 Proteus mirabilis 71 0.7 Coryebacterium spp 70 0.6 ß haemolytic Streptococci Group B 69 0.6 Salmoella spp 67 0.6 Helicobacter spp 64 0.6 Fastidious GNB 57 0.5 Pseudomoas spp 56 0.5 Klebsiella aerogees 50 0.5 % 6 72 89 6 14 31 92 15 15 95 51 80 *70 *69 *70 *68 *64 *65 *72 *71 *47 75 *73 *10 % 80 94 100 89 97 100 100 93 100 90 96 71 71 71 71 71 70 71 71 *60 71 71 % 51 50 36 54 100 34 19 96 100 69 *16 *44 *13 *11 *44 69 69 *59 % 100 100 100 100 100 29 70 70 25 100 69 68 *62 *33 69 *21 69 69 69 *58 % 87 97 100 100 97 98 97 67 64 *63 *57 67 *59 *61 % 95 75 100 62 64 62 % 97 98 100 100 100 100 80 98 100 100 *31 *54 *54 *12 *33 *14 *10 *54 *30 *44 % R 9 80 R 33 94 66 98 100 11 96 56 56 *15 54 56 56 *42 56 56 % R R 74 R R 72 96 98 100 100 96 96 50 50 49 50 50 *42 50 50 Page: 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 10843 100 Morgaella spp 46 0.4 Citrobacter koseri, amaloaticus group 40 0.4 Acietobacter spp 36 0.3 Citrobacter freudii complex 31 0.3 Miscellaeous GPC 30 0.3 % R R 89 R 89 95 96 93 100 96 96 46 46 44 46 46 *42 46 46 % R 95 95 93 98 98 100 100 100 95 100 40 40 40 40 40 40 40 *37 40 40 % R R 72 R R 65 81 100 100 100 94 100 36 *31 *26 36 36 *24 36 36 % R R 48 R 48 77 100 81 93 81 84 31 31 30 31 31 *28 31 31 % 79 95 95 86 95 95 100 100 96 96 95 97 *28 *21 *20 *22 *22 *21 *20 *20 *23 *24 *22 29 Page: 11
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 1 3.2 Citrobacter freudii 3 9.7 Citrobacter koseri, amaloaticus group = 40 Citrobacter koseri 1 2.5 Eterobacter cloacae complex = 259 Eterobacter asburiae 2 0.8 Eterobacter cloacae 23 8.9 Escherichia spp = 775 Escherichia coli 122 15.7 Klebsiella aerogees = 50 Eterobacter aerogees 1 2.0 Klebsiella spp = 312 Klebsiella peumoiae 28 9.0 Serratia spp = 120 Serratia marcesces 1 0.8 NoUrie: Plasmid mediated AMPC producig Eterobacterales (PAMP) Orgaism Name % of Strai Escherichia spp = 775 Escherichia coli 47 6.1 Klebsiella spp = 312 Klebsiella oxytoca 1 0.3 Klebsiella peumoiae 3 1.0 Proteus mirabilis = 71 Proteus mirabilis 2 2.8 NoUrie: Plasmid mediated Carbapeemase producig Eterobacterales (CPE) Orgaism Name % of Strai Citrobacter freudii complex = 31 Citrobacter freudii 1 3.2 Eterobacter cloacae complex = 259 Eterobacter cloacae 9 3.5 NoUrie: Plasmid mediated Carbapeemase producig No Eterobacterales (CPNE) Page: 12
Orgaism Name % of Strai NoUrie: Vacomyci Resistat Eterococci (VRE) Orgaism Name % of Strai Eterococcus spp = 317 Eterococcus faecium (VRE) - VAN-A 3 0.9 Eterococcus faecium (VRE) - VAN-B 5 1.6 NoUrie: Methicilli Resistat Staphylococcus aureus (MRSA) Orgaism Name % of Strai Staphylococcus aureus (ALL) = 3292 S.aureus (o-multiresistat MRSA) 320 9.7 Staphylococcus aureus (MRSA) 32 1.0 Staphylococcus aureus (UK EMRSA-15) 86 2.6 NoUrie: Streptococcus peumoiae Peicilli Susceptibility (No-meigitis breakpoits) MIC category % of Strai Streptococcus peumoiae = 120 Sesitive 0.06 mg/l 66 55.0 Itermediate 0.12-2 mg/l 52 43.3 Resistat > 2 mg/l 2 1.7 NoUrie: Streptococcus peumoiae Ceftriaxoe Susceptibility MIC category % of Strai Streptococcus peumoiae = 120 Sesitive 0.5 mg/l 24 20.0 NoUrie: Streptococcus alpha haem (viridas Streptococci) Peicilli Susceptibility Itermediate 1-2 mg/l 6 5.0 Page: 13
MIC category % of Strai viridas Streptococci = 354 Sesitive 0.06 mg/l 323 91.2 Itermediate 0.12-1 mg/l 27 7.6 Resistat 2 mg/l 4 1.1 Page: 14
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 2142 100.0 Coagulase egative Staphylococci 637 29.7 Escherichia spp 407 19.0 Staphylococcus aureus (ALL) 211 9.9 Klebsiella spp 147 6.9 viridas Streptococci 118 5.5 Pseudomoas aerugiosa 100 4.7 Eterococcus spp 90 4.2 Spore formig GPB 57 2.7 Eterobacter cloacae complex 56 2.6 % 11 41 40 40 R 59 79 79 98 44 64 68 100 627 621 621 621 629 609 623 626 626 625 628 632 % 43 79 92 77 90 93 100 91 99 69 86 407 407 406 407 407 406 407 407 *329 407 407 % 26 89 89 89 R 95 92 95 100 86 87 95 100 211 211 211 211 211 *185 *186 *186 211 211 211 211 % R 94 92 84 93 95 100 99 100 86 93 147 147 147 147 147 147 147 *119 147 147 % 85 100 89 68 R 100 50 85 74 100 117 *15 115 *25 *83 117 117 117 116 % R R 89 R R 92 94 94 96 96 R 94 R 100 100 100 100 100 *77 100 % 77 R R R R R R 43 81 R R 30 33 87 90 *23 *83 90 *76 90 % 17 75 92 97 76 49 78 98 *54 *12 *25 *39 *21 *53 *50 *52 % R R 66 R 71 86 98 93 100 77 93 56 56 56 56 56 *43 56 56 Page: 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 2142 100.0 ß haemolytic Streptococci Group B 30 1.4 % 100 100 100 100 100 30 70 70 23 100 30 30 29 *26 30 *10 30 30 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 1 11.1 Eterobacter cloacae complex = 56 Eterobacter cloacae 3 5.4 Escherichia spp = 407 Escherichia coli 38 9.3 Klebsiella spp = 147 Klebsiella peumoiae 7 4.8 Serratia spp = 21 Serratia marcesces 1 4.8 Blood Culture: Plasmid mediated AMPC producig Eterobacterales (PAMP) Orgaism Name % of Strai Escherichia spp = 407 Escherichia coli 8 2.0 Klebsiella spp = 147 Klebsiella peumoiae 1 0.7 Page: 16
Blood Culture: Plasmid mediated Carbapeemase producig Eterobacterales (CPE) Orgaism Name % of Strai Citrobacter freudii complex = 9 Citrobacter freudii 1 11.1 Eterobacter cloacae complex = 56 Eterobacter cloacae 2 3.6 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 1 1.1 Eterococcus faecium (VRE) - VAN-B 4 4.4 Blood Culture: Methicilli Resistat Staphylococcus aureus (MRSA) Orgaism Name % of Strai Staphylococcus aureus (ALL) = 211 S.aureus (o-multiresistat MRSA) 16 7.6 Staphylococcus aureus (MRSA) 3 1.4 Staphylococcus aureus (UK EMRSA-15) 4 1.9 Blood Culture: Streptococcus peumoiae Peicilli Susceptibility (No-meigitis breakpoits) MIC category % of Strai Streptococcus peumoiae = 25 Sesitive 0.06 mg/l 16 64.0 Blood Culture: Streptococcus peumoiae Ceftriaxoe Susceptibility Itermediate 0.12-2 mg/l 9 36.0 Page: 17
MIC category % of Strai Streptococcus peumoiae = 25 Sesitive 0.5 mg/l 23 92.0 Blood Culture: Streptococcus alpha haem (viridas Streptococci) Peicilli Susceptibility Itermediate 1-2 mg/l 2 8.0 MIC category % of Strai viridas Streptococci = 117 Sesitive 0.06 mg/l 100 85.5 Itermediate 0.12-1 mg/l 14 12.0 Resistat 2 mg/l 3 2.6 Miscellaeous orgaism groupigs detail report. Page: 18