Antibiotic Resistance Pattern of Blood and CSF Culture Isolates At NHLS Academic Laboratories (2005)

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Antibiotic Resistance Pattern of Blood and CSF Culture Isolates At NHLS Academic Laboratories (2005) Streptococcus pneumoniae (SP) Blood Culture Isolates Penicillin intermediate Penicillin Cefotaxime 336 16% 21% 0.6% 109 60% 1% 0% Green Point 43 14% 0% 0% Groote Schuur 144 30% 1% 1% Johannesburg 214 30% 0.5% 0% 98 32% 14% 0% Tygerberg 31 42% 3% 0% Universitas 46 35% 7% 2% MICs for CSF were used to determine the resistance of penicillin and cefotaxime because some were from meningitis patients. Penicillin MIC: < 0.06mg/l =susceptible 0.12 1 mg/l = intermediate resistant > 2mg/l = resistant Cefotaxime MIC: < 0.5mg/l = susceptible 1 2 mg/l = intermediate resistant > 4mg/l = resistant 1

Streptococcus pneumoniae CSF Culture Isolates Penicillin intermediate Penicillin Cefotaxime 136 24% 10% 0% 6% 17% 0% 0% Green Point 26 15% 0% 0% Groote Schuur 24 21% 0% 0% Johannesburg 29 10% 0% 0% 19 Not Available* 11%* 0% Tygerberg 7 14% 0% 0% Universitas 28 29% 4% 0% * = combined % of penicillin intermediate & resistant Penicillin MIC: < 0.06mg/l =susceptible 0.12 1 mg/l = intermediate resistant > 2mg/l = resistant Cefotaxime MIC: < 0.5mg/l = susceptible 1 2 mg/l = intermediate resistant > 4mg/l = resistant 2

Haemophilus influenzae & Neisseria meningitidis Blood Culture Isolates of HI H influenzae (HI) of Ampicillin Resistant HI of betalactamase producing HI Neisseria meningitidis (NM) number number of of NM penicillin reduced susceptible NM 23 8 5 8 0 6 3 3 0 0 Green Point 5 0 0 5 0 Groote Schuur 4 0 0 5 1 Johannesburg 11 1 1 16 0 0 0 0 0 0 Tygerberg 4 2 2 1 0 Universitas 4 0 0 2 0 Haemophilus influenzae & Neisseria meningitidis CSF Culture Isolates of HI H influenzae (HI) of Ampicillin Resistant HI of betalactamase producing HI Neisseria meningitidis (NM) number of penicillin of NM reduced susceptible NM 5 1 1 15 0 2 1 1 2 0 Green Point 0 0 0 3 0 Groote Schuur 5 0 0 7 0 Johannesburg 3 1 0 0 0 0 0 0 3 0 Tygerberg 1 1 1 4 0 Universitas 1 0 0 2 0 3

Streptococcus agalactiae Streptococcus group B blood culture of Streptococcus agalactiae isolated from blood culture specimens at Chris Hani,, Greenpoint, Groote Schuur, Johannesburg,, Tygerberg and Universitas NHLS laboratories are 72, 22, 9, 26, 29, 8, 16, and 9 respectively. All of theses were sensitive to penicillin. Enterococcus faecalis (EF) blood culture Ampicillin resistant EF Beta lactamase producing EF High level gentamicin resistant EF 83 10% 1% 33% 50 48% 2% 44% Green Point 15 0% 0% 0% Groote Schuur 45 2% 0% 49% Johannesburg 43 26% 26% 5% 75 21% 19% 31% Tygerberg 16 13% 6% 13% Universitas 16 0% 0% 31% Staphylococcus aureus blood culture MRSA% 431 56% 129 69% Green Point 65 35% Groote Schuur 202 57% Johannesburg 251 37% 236 55% Tygerberg 84 48% Universitas 79 53% 4

Salmonella typhi (STY) blood culture Ampicillin resistant STY Co trimoxazole resistant STY 3 0 0 1 0 0 Green Point 2 0 0 Groote Schuur 2 1 0 Johannesburg 0 0 0 6 0 0 Tygerberg 2 1 1 Universitas 0 0 0 All the Salmonella typhi were sensitive to ceftriaxone and ciprofloxacin. Non typhoidal Salmonella species (S) blood culture Rankuwa/Medunsa) Ampicillin resistant S Cotrimoxazole resistant Ceftriaxone resistant S resistant S 216 75% 63% 39% 1% 52 29% 2% 4% 0% Green Point 17 24% 24% 0% 0% Groote Schuur 29 38% 38% 21% 0% Johannesburg 76 68% 63% 14% 5% 14 14% 14% 0% 0% Tygerberg 1 100% 100% 0% 0% Universitas 8 13% 13% 0% 0% 5

E coli (EC) blood culture Rankuwa/Medunsa) Ampicillin resistant EC resistant EC Gentamicin resistant EC Extended spectrum beta lactamase producing EC 329 90% 11% 21% 25% 72 86% 26% 31% 17% Green Point 39 87% 3% 15% 10% Groote Schuur 113 80% 7% 15% 10% Johannesburg 136 83% 13% 15% 8% 122 64% 8% 4% 3% Tygerberg 51 78% 20% 18% 25% Universitas 28 86% 11% 4% 4% Klebsiella pneumoniae (KP) blood culture Rankuwa/Medunsa) Gentamicin resistant KP resistant KP Extended spectrum beta lactamase producing KP 248 56% 34% 50% 122 76% 18% 54% Green Point 44 55% 20% 43% Groote Schuur 175 66% 45% 70% Johannesburg 130 28% 19% 25% 161 45% 27% 42% Tygerberg 53 47% 32% 58% Universitas 55 55% 9% 53% 6

Enterobacter species (E) blood culture Rankuwa/Medunsa) Gentamicin resistant E resistant E Extended spectrum beta lactamase producing E 94 32% 9% 30% 19 37% 11% 32% Green Point 4 25% 0% 0% Groote Schuur 35 43% 9% 51% Johannesburg 83 19% 10% 6% 81 16% 12% 16% Tygerberg 28 25% 4% 7% Universitas 20 15% 0% 10% 7

Pseudomonas aeruginosa (PA) blood culture Gentamicin Piperacillin/ tazobactam Ceftazidime Imipenem Meropenem 87 33% 18% 16% 14% 23% 26% Rankuwa/Medunsa) 43 7% 5% 0% 5% 5% 2% Green Point 5 20% 0% 0% 0% 0% 0% Groote Schuur 28 25% 11% 0% 14% 57% 50% Johannesburg 74 22% 14% 23% 16% 22% 19% 141 13% 39% 40% 38% 44% 41% Tygerberg 34 44% 21% 18% 9% 29% 47% Universitas 11 9% 9% 9% 0% 9% 9% 8

Acinetobacter species (A) blood culture Piperacillin/ tazobactam Ceftazidime Imipenem Meropenem 163 72% 65% 61% 63% 65% Rankuwa/Medunsa) 88 76% 75% 82% 81% 73% Green Point 2 0% 0% 0% 0% 0% Groote Schuur 104 45% 51% 37% 38% 38% Johannesburg 43 49% 40% 42% 19% 19% 85 64% 69% 74% 59% 67% Tygerberg 50 68% 68% 62% 64% 64% Universitas 10 70% 70% 70% 60% 60% 9