Poster Presentation Australian Society for Microbiology Annual Scientific Meeting 2018

Study for Monitoring Antimicrobial Resistance Trends (SMART) in Australia and New Zealand (ANZ), 2016-2017 (#384)

Robert Badal 1 , Geoff Coombs 2 , Dragana Drinkovic 3 , Justin Ellem 4 , Narelle George 5 , Andree Hubber 6 , Tony Korman 7 , Sally Roberts 8 , Susan Taylor 9 , Merrin Tulloch 6
  1. IHMA Inc , Schaumberg, IL, USA
  2. Murdoch University , Perth , WA , Australia
  3. North Shore Hospital , Auckland , New Zealand
  4. Westmead Hospital, Sydney , NSW, Australia
  5. Pathology Queensland , Brisbane , QLD, Australia
  6. MSD, Macquarie Park, NSW, Australia
  7. Monash Health , Melbourne, VIC , Australia
  8. Auckland City Hospital , Auckland , New Zealand
  9. Middlemore Hospital , Auckland, New Zealand

SMART has monitored the in vitro susceptibility patterns of clinical Gram-negative bacilli to antimicrobial agents in ANZ from intra-abdominal infections since 2002, urinary tract infections since 2009 and respiratory infections since 2015. This update includes suceptibility data from 2016-2017.

 

The top three pathogens for intra-abdominal infections (n=7112) were Escherichia coli (48%), Klebsiella pneumoniae (12%) and Pseudomonas aeruginosa (11%). Of these the most common sources were peritoneal fluid (36%), abscess (16%) and gallbladder (12%). The top three pathogens for patients with urinary infections (n=3530) were E. coli (57%), K. pneumoniae (14%) and P. aeruginosa (8%), and the most common sources were urine (93%) and kidney (6%).  The top three pathogens from patients with respiratory infections (n=2085) were P. aeruginosa (35%), E. coli (14%), and K. pneumoniae (13%). Of these the most common sources were sputum (63%), endotracheal aspirate (27%) and bronchoalveolar lavage (9%).  Excluding sputum isolates from respiratory samples the prevalence was P. aeruginosa (23%), K. pneumoniae (16%) and E. coli (15%).

 

Amongst 2833 Enterobacteriaceae from 2016-2017, rank order non-susceptibility (NS) was ceftriaxone (CRO, 20%), ceftazidime (CAZ, 18%), ciprofloxacin (CIP, 15%), piperacillin/tazobactam (PTZ, 13%), cefepime (FEP, 13%) and ceftolozane/tazobactam (C/T, 8%)†.  NS to imipenem (IPM), meropenem (MEM) and amikacin (AMK) was ~1%.   Of 212 CRO NS E. coli isolates from 2016-2017, rank order NS was PTZ (25%), C/T (17%), ETP (4%), AMK (7%), colistin (COL, 1%) and MEM or IPM (0%).  Molecular analysis of E. coli (n=75) and K. pneumoniae (n=34) from 2016 confirms predominance of CTX-M-type extended-spectrum β-lactamases.

 

Amongst 727 Pseudomonas aeruginosa from 2016-2017, rank order NS was CIP (18%), PTZ (15%), FEP (13%), CAZ (13%), MEM (11%) and IPM (10%).  NS to C/T and colistin was ≤ 3%.  Of 81 MEM NS isolates, rank order NS was IPM (79%), TZP (60%), FEP (54%), CIP (49%), CAZ (48%), AMK (19%), C/T (17%) and COL (1%). Of 93 CAZ NS isolates, rank order NS was TZP (89%), FEP (69%), MEM (42%), CIP (39%), IPM (38%), C/T (22%), AMK (15%) and COL (1%). Molecular analysis of P. aeruginosa (n=67) isolates from 2016 identified a single acquired carbapenemase.

 

† EUCAST criteria