BSAC Bacteraemia Resistance Surveillance Update 2012 #63 V. Martin1, S. Mushtaq2, D.M. Livermore2 , R. Reynolds1 and The BSAC Extended Working Party on Resistance Surveilance1
1British Society for Antimicrobial Chemotherapy, Birmingham, B1 2JS 2 Public Health England, Colindale, London, NW9 5EQ
• The BSAC Bacteraemia Resistance Surveillance Programme has
• Clinical laboratories collect up to a defined quota of isolates from
been monitoring antimicrobial susceptibility in the major
January to December in each surveil ance year.
organisms causing bacteraemia in the UK and Ireland since 2001.
• MICs are measured and interpreted by BSAC methods.
• In 2012, the BSAC Bacteraemia Resistance Surveillance
• 2012 results were compared primarily with data for the five
Programme collected 3,205 blood isolates from 39 laboratories in
• See www.bsacsurv.org or JAC, 2008. 62, suppl 2 ii15 - ii28 GRAM POSITIVE BACTERIA GRAM-NEGATIVE BACTERIA Staphylococci Pseudomonas aeruginosa
• MRSA continued to decline to 12% of 515 S. aureus in 2012 from
• Non-susceptibility (NS) in P. aeruginosa has changed little over
45% in 2006 and 5-year average 2007-11 of 24%.
12 years’ surveillance. Of 218 isolates in 2012, 23 were imipenem
• Non-susceptibility (NS) of S. aureus to ciprofloxacin (16%) and
NS, one being a VIM metallo-β-lactamase producer. All were
erythromycin (17%) was also lower in 2012; mupirocin NS (2%)
and gentamicin NS (3%) were little changed.
• NS rates in 203 isolates of coagulase-negative staphylococci
were similar to previous years, with 77% methicillin-resistant.
• Rates of ESBL production(11%) and ciprofloxacin NS (24%)
noted in 520 E. coli in 2012 have clearly risen from their 2009-10
Streptococci and enterococci
troughs of 6% and 15%, respectively. Little or no such increase
• Penicillin NS in 229 S. pneumoniae in 2012 was stable at 6%, all
was seen by 2012 in 251 Klebsiella (11% ESBL, 11% CIP-NS) or
intermediate with MIC ≤2 mg/L. Rates of clindamycin resistance
203 Enterobacter (7% ESBL, 6% CIP-NS).
(7%, all high-level, MIC >128 mg/L) and dual or multiple-agent NS (9%) were similar to 2011 but higher than in the previous 5 years.
• AmpC hyper-production was found in 12% of Enterobacter and
• 190 other α-haemolytic streptococci showed similar rates of
non-susceptibility as in previous years with 15% penicillin NS,
• Gentamicin NS changed little in any Gram-negative group.
10% amoxicillin NS and 37% erythromycin NS.
• Carbapenems All E. coli, Enterobacter and Serratia and 250/251
• All of 244 β-haemolytic streptococci were penicillin susceptible Klebsiella were susceptible to imipenem, the exception being a
single VIM-producing isolate of K. pneumoniae.
• There was little change in NS among enterococci. All were
• Colistin non-susceptibility was seen in 6% of Enterobacter
susceptible to tigecycline and linezolid. All of 128 E. faecalis were
isolates compared with <2% among E. coli and Klebsiella.
susceptible to ampicil in and impenem, and only 2% were NS to vancomycin; 30% of 115 E. faecium were vancomycin NS.
Non-susceptibility in gram-negative bacteria, 2012
Methicillin resistance in S. aureus has continued to fall since 2009 but not as steeply as between 2006 and 2008.
ESBLs and ciprofloxacin resistance in E.coli have risen again, from a trough around 2009-2010.
Resistance rates are still low in S. pneumoniae; changing patterns may reflect selective pressure from vaccines. Abbreviations:
ESBL extended-spectrum β-lactamase, MRSA methicillin-resistant S. aureus. CAZ ceftazidime, CIP ciprofloxacin, CLI clindamycin, ERY erythromycin, FUS fusidic acid, GEN gentamicin, IPM imipenem, PEN penicillin, TET tetracycline, TGC tigecycline, TZP piperacillin-tazobactam. R resistant, NS non-susceptible. Extended Working Party Members (October 2013): A. MacGowan1 (Chair), M. Allen2, D. Brown3, P. Fernandes4, H. Grundmann5, R. Janes6, A. Johnson7, M. Jones,8 A. Kidney6, D. Livermore7, S. McCurdy9, V. Martin1, T. Mepham10, S. Mushtaq7, S. Peacock11, J. Porter12, R. Reynolds1, C. Thomson13. Organism ID and Susceptibility Testing: S. Mushtaq7 and staff at Public Health England - Colindale 1North Bristol NHS Trust ; 2Novartis; 3EUCAST Scientific Secretary; 4Cempra, 5RIVM ; 6Quotient BioAnalytical Sciences, Fordham; 7Public Health England, London; 8Basilea; 9Cubist; 10AstraZeneca; 11University of Cambridge; 12Pfizer; 13Astellas. Collecting Laboratories: See www.bsacsurv.org Sponsors 2012: Basilea, Cempra, Cubist, Pfizer. Support: BSAC
Dr R. Reynolds, BSAC Resistance Surveillance Project Coordinator, FIS, Birmingham, 11–13 Nov 2013
Department of Medical Microbiology, Southmead Hospital, Bristol,BS10 5NB
www.bsac.org.uk [email protected]
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