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Surveillance of Gram-negative bacteria: impact of variation in current European laboratory reporting practice on apparent multidrug resistance prevalence in paediatric bloodstream isolates.

Bielicki, JA; Cromwell, DA; Johnson, A; Planche, T; Sharland, M; ARPEC project, (2017) Surveillance of Gram-negative bacteria: impact of variation in current European laboratory reporting practice on apparent multidrug resistance prevalence in paediatric bloodstream isolates. Eur J Clin Microbiol Infect Dis, 36 (5). pp. 839-846. ISSN 1435-4373 https://doi.org/10.1007/s10096-016-2869-4
SGUL Authors: Planche, Timothy David Sharland, Michael Roy Bielicki, Julia Anna

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Abstract

This study evaluates whether estimated multidrug resistance (MDR) levels are dependent on the design of the surveillance system when using routine microbiological data. We used antimicrobial resistance data from the Antibiotic Resistance and Prescribing in European Children (ARPEC) project. The MDR status of bloodstream isolates of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa was defined using European Centre for Disease Prevention and Control (ECDC)-endorsed standardised algorithms (non-susceptible to at least one agent in three or more antibiotic classes). Assessment of MDR status was based on specified combinations of antibiotic classes reportable as part of routine surveillance activities. The agreement between MDR status and resistance to specific pathogen-antibiotic class combinations (PACCs) was assessed. Based on all available antibiotic susceptibility testing, the proportion of MDR isolates was 31% for E. coli, 30% for K. pneumoniae and 28% for P. aeruginosa isolates. These proportions fell to 9, 14 and 25%, respectively, when based only on classes collected by current ECDC surveillance methods. Resistance percentages for specific PACCs were lower compared with MDR percentages, except for P. aeruginosa. Accordingly, MDR detection based on these had low sensitivity for E. coli (2-41%) and K. pneumoniae (21-85%). Estimates of MDR percentages for Gram-negative bacteria are strongly influenced by the antibiotic classes reported. When a complete set of results requested by the algorithm is not available, inclusion of classes frequently tested as part of routine clinical care greatly improves the detection of MDR. Resistance to individual PACCs should not be considered reflective of MDR percentages in Enterobacteriaceae.

Item Type: Article
Additional Information: © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Bacteremia, Drug Resistance, Multiple, Bacterial, Epidemiological Monitoring, Europe, Gram-Negative Bacteria, Gram-Negative Bacterial Infections, Humans, Microbial Sensitivity Tests, Prevalence, Microbiology, 06 Biological Sciences, 11 Medical And Health Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Eur J Clin Microbiol Infect Dis
ISSN: 1435-4373
Language: eng
Dates:
DateEvent
May 2017Published
26 December 2016Published Online
6 December 2016Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
A 2009 - 11 - 01Executive Agency for Health and Consumershttp://dx.doi.org/10.13039/501100000810
PubMed ID: 28025699
Web of Science ID: WOS:000399694500011
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/108444
Publisher's version: https://doi.org/10.1007/s10096-016-2869-4

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