Residential Aged Care Antibiogram Jan - Dec 2016 Residential Aged Care Antibiogram Jan - Dec 2016

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1 Residetial Aged Care Atibiogram Ja - Dec 2016 Residetial Aged Care Atibiogram Ja - Dec 2016 Page: 1

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 your Residetial Aged Care Facility (RACF). It is divided ito three parts 1. Uriary Atibiogram 2. No Uriary Atibiogram 3. Blood Culture Atibiogram (this is a subset of the No Uriary Atibiogram but oly provided if sufficiet data is available). 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.² Expert EUCAST rules i Atimicrobial Susceptibility testig have bee applied.³ Residetial Aged Care Atibiogram Ja - Dec 2016 Where the total umber of isolates tested is < 30, results are cosidered statistically ivalid i accordace with CLSI M39-A2⁴ ad have therefore ot bee icluded. 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. The % susceptibility has ot bee colour coded. 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 Eterobacteriaceae resistat to third or fourth geeratio cephalosporis due to the presece of Exteded Spectrum Beta Lactamases (ESBLs) Eterobacteriaceae resistat to third or fourth geeratio cephalosporis due to the presece of Plasmid Mediated AMPC productio (PAMPs) Eterobacteriaceae resistat to carbapeems due to the presece of a plasmid mediated carbapeamase (CPE) No Eterobacteriaceae (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 itermediate ad vacomyci 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. Residetial Aged Care Atibiogram Ja - Dec 2016 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 partcular 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-A2). 3rd ed. Pesylvaia: CLSI, Page: 3

4 Residetial Aged Care Atibiogram Ja - Dec 2016 Urie Atibiogram All SNP Nursig Home Orgaisms %Total Amoxycilli Amoxycilli/Clavulaate Ticarcilli/Clavulaate Pipericilli/Tazobactam Cephalexi Ceftriaxoe Ceftazidime Meropeem Getamici Amikaci Trimethoprim Nitrofuratoi Norfloxaci Fusidic Acid Rifampici Getamici (High Level) Fosfomyci Quiupristi/dalfopristi Vacomyci All isolates Escherichia spp % *2648 *226 * *446 *254 *457 * *141 Eterococcus spp % 94 R *21 *21 *22 *52 Klebsiella spp % R *598 *41 * *83 *36 *85 * *18 Pseudomoas aerugiosa Proteus mirabilis Eterobacter cloacae complex Staphylococcus aureus Citrobacter koseri ß haemolytic Streptococci Citrobacter freudii complex % R R R R R 96 * *12 *300 % R *308 *21 * *40 *41 * % R R R *35 *66 *72 *22 *74 * % * *110 *68 *68 *68 % R * % *46 % R R R *14 *21 *20 * Page: 4

5 Residetial Aged Care Atibiogram Ja - Dec 2016 Urie Atibiogram All SNP Nursig Home Orgaisms %Total Amoxycilli Amoxycilli/Clavulaate Ticarcilli/Clavulaate Pipericilli/Tazobactam Cephalexi Ceftriaxoe Ceftazidime Meropeem Getamici Amikaci Trimethoprim Nitrofuratoi Norfloxaci Fusidic Acid Rifampici Getamici (High Level) Fosfomyci Quiupristi/dalfopristi Vacomyci All isolates Coagulase egative Staphylococci Morgaella spp Eterobacter aerogees Miscellaeous GPC % * *55 56 *12 *12 *12 % R R R R 92 *18 *43 * % R R 43 R *14 *14 * % * Page: 5

6 Residetial Aged Care Atibiogram Ja - Dec 2016 Sigal Resistaces: Where the tables below cotai o data o multiresistat orgaisms have bee detected. Urie: Exteded spectrum beta lactamase producig Eterobacteriaceae (ESBL) Orgaism Name % of Strai Citrobacter freudii complex = 70 Citrobacter freudii Eterobacter aerogees = 51 Eterobacter aerogees Eterobacter cloacae complex = 156 Eterobacter cloacae Escherichia spp = 2931 Escherichia coli Klebsiella spp = 638 Klebsiella oxytoca Klebsiella peumoiae Morgaella spp = 52 Morgaella morgaii Proteus mirabilis = 336 Proteus mirabilis Proteus spp other = 16 Proteus vulgaris group Urie: Plasmid mediated AMPC producig Eterobacteriaceae (PAMP) Orgaism Name % of Strai Citrobacter koseri = 81 Citrobacter koseri Escherichia spp = 2931 Escherichia coli Klebsiella spp = 638 Klebsiella oxytoca Klebsiella peumoiae Proteus mirabilis = 336 Proteus mirabilis Proteus spp other = 16 Proteus vulgaris Pseudomoas aerugiosa = 452 Pseudomoas aerugiosa Urie: Plasmid mediated Carbapeemase producig Eterobacteriaceae (CPE) Page: 6

7 Residetial Aged Care Atibiogram Ja - Dec 2016 Orgaism Name % of Strai Eterobacter cloacae complex = 156 Eterobacter cloacae Klebsiella spp = 638 Klebsiella peumoiae Urie: Plasmid mediated Carbapeemase producig No Eterobacteriaceae (CPNE) Orgaism Name % of Strai Urie: Vacomyci Resistat Eterococci (VRE) Orgaism Name % of Strai Eterococcus spp = 742 Eterococcus faecium (VRE) - VAN-A Eterococcus faecium (VRE) - VAN-B Urie: Methicilli Resistat Staphylococcus aureus (MRSA) Orgaism Name % of Strai Staphylococcus aureus = 123 S.aureus (o-multiresistat MRSA) Staphylococcus aureus (MRSA) Staphylococcus aureus (UK EMRSA-15) Page: 7

8 Residetial Aged Care Atibiogram Ja - Dec 2016 No-urie Atibiogram All SNP Nursig Home Orgaisms %Total Peicilli Amoxycilli Flucloxacilli Amoxycilli/Clavulaate Ticarcilli/Clavulaate Pipericilli/Tazobactam Cephalothi Cefazoli Ceftriaxoe Ceftazidime Meropeem Getamici Sulphamethoxazole/Trimethoprim Ciprofloxaci Fusidic Acid Rifampici Erythromyci/Clarithromyci Clidamyci Tetracyclie Vacomyci All isolates Staphylococcus aureus % * *552 * *554 Pseudomoas % R R R R 94 * aerugiosa Haemophilus ifluezae % ß haemolytic % Streptococci Moraxella catarrhalis Escherichia spp % % *12 32 *14 * *11 Page: 8

9 Residetial Aged Care Atibiogram Ja - Dec 2016 Sigal Resistaces: Where the tables below cotai o data o multiresistat orgaisms have bee detected. NoUrie: Exteded spectrum beta lactamase producig Eterobacteriaceae (ESBL) Orgaism Name % of Strai Eterobacter cloacae complex = 7 Eterobacter cloacae Escherichia spp = 35 Escherichia coli Klebsiella spp = 19 Klebsiella peumoiae NoUrie: Plasmid mediated AMPC producig Eterobacteriaceae (PAMP) Orgaism Name % of Strai Escherichia spp = 35 Escherichia coli Klebsiella spp = 19 Klebsiella peumoiae NoUrie: Plasmid mediated Carbapeemase producig Eterobacteriaceae (CPE) Orgaism Name % of Strai NoUrie: Plasmid mediated Carbapeemase producig No Eterobacteriaceae (CPNE) Orgaism Name % of Strai Page: 9

10 NoUrie: Vacomyci Resistat Eterococci (VRE) Residetial Aged Care Atibiogram Ja - Dec 2016 NoUrie: Methicilli Resistat Staphylococcus aureus (MRSA) Orgaism Name % of Strai Staphylococcus aureus = 1825 S.aureus (o-multiresistat MRSA) Staphylococcus aureus (MRSA) Staphylococcus aureus (UK EMRSA-15) NoUrie: Streptococcus peumoiae Peicilli Susceptibility ** (Oral peicilli V breakpoits) MIC category % of Strai Streptococcus peumoiae = 10 Itermediate mg/l Sesitive 0.06 mg/l Page: 10

11 Residetial Aged Care Atibiogram Ja - Dec 2016 Blood Cultures: There are o isolates where is 30 or greater. Sigal Resistaces: Where the tables below cotai o data o multiresistat orgaisms have bee detected. Blood Culture: Exteded spectrum beta lactamase producig Eterobacteriaceae (ESBL) Orgaism Name % of Strai Blood Culture: Plasmid mediated AMPC producig Eterobacteriaceae (PAMP) Orgaism Name % of Strai Blood Culture: Plasmid mediated Carbapeemase producig Eterobacteriaceae (CPE) Orgaism Name % of Strai Eterobacter cloacae complex = 156 Eterobacter cloacae Klebsiella spp = 638 Klebsiella peumoiae Blood Culture: Plasmid mediated Carbapeemase producig No Eterobacteriaceae (CPNE) Orgaism Name % of Strai Page: 11

12 Residetial Aged Care Atibiogram Ja - Dec 2016 Blood Culture: Vacomyci Resistat Eterococci (VRE) Orgaism Name % of Strai Blood Culture: Methicilli Resistat Staphylococcus aureus (MRSA) Orgaism Name % of Strai Staphylococcus aureus = 1 S.aureus (o-multiresistat MRSA) Page: 12

13 Residetial Aged Care Atibiogram Ja - Dec 2016 Miscellaeous orgaism groupigs detail report. Page: 13