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EARS-Net (European Antimicrobial Resistance Surveillance Network European Antimicrobial Resistance Surveillance Network (EARS-Net) Belgium, isolates from 2013 EARS -Net (European Antimicrobial Resistance Survei llance Network) Isolates from 2013, Belgium European Antimicrobial Resistance Surveillance Network (EARS-Net) Belgium, isolates from 2013 WIV-ISP Public health & surveillance Health care associated infections & antimicrobial resistance Rue Juliette Wytsmanstraat 14 1050 Brussels E-mail : [email protected] www.nsih.be Mathijs-Michiel Goossens August 2014; Brussels (Belgium) European Antimicrobial Resistance Surveillance Network (EARS-Net) Belgium, isolates from 2013 1. TABLE OF CONTENT 1. TABLE OF CONTENT 2. INTRODUCTION 3. ABBREVIATION 4. ANTIMICROBIAL CODES (ECDC) 5. SUMMARY 6. ANTIMICROBIAL GROUPS 7. DISCUSSION OF ERROR & BIAS 7.1 Selection bias 7.1.1. Sample bias 7.1.2. Attrition 7.2 Measurement bias 7.2.1. incorrect AMR measurement 7.2.2. Advised breakpoints 7.2.3. Data transfer 8. RESISTANCE PATTERNS PER GERM 8.1 S. aureus 8.1.1 Relevance in AMR surveillance 8.1.2 Resistance mechanisms 8.2 S. pneumoniae 8.2.1 Relevance in AMR surveillance 8.2.2 Resistance mechanisms 8.3 E. coli 8.3.1 Relevance in AMR surveillance 8.3.2 Resistance mechanisms 8.4 K. pneumoniae 8.4.1 Relevance in AMR surveillance 8.4.2 Resistance mechanisms 8.5 E. faecalis en E. faecium 8.5.1 Relevance in AMR surveillance 8.5.2 Resistance mechanisms 8.6 P. aeruginosa 8.6.1 Relevance in AMR surveillance 8.6.2 Resistance mechanisms 9. RESULTS 10. ACKNOWLEDGEMENTS 11. FUTURE PARTICIPATION European Antimicrobial Resistance Surveillance Network (EARS-Net) Belgium, isolates from 2013 2. INTRODUCTION EARS-Net performs AMR (Antimicrobial resistance) surveillance for seven bacterial pathogens: • S. pneumoniae • S. aureus • E. faecalis • E. faecium • E. coli • K. pneumoniae • P. aeruginosa More information can be found in the EARS-Net reports available at http://ecdc.europa.eu/en/publications/Publications/Forms/ECDC_DispForm.aspx?ID=998 The chapter about AMR resistance patterns has mostly been copied from an EARS-Net report published by ECDC. The results graphs were done at the WIV-ISP. A number of things should be remembered when interpreting the results (see also chapter “Error & Bias”): • EARS-Net data are exclusively based on invasive isolates (blood or cerebrospinal fluid). This restriction pre- vents inconsistencies that arise from differences in clinical case definitions, different sampling frames or het- erogeneous healthcare utilization that would otherwise confound the data analysis if isolates from all ana- tomical sources were accepted. However, invasive isolates may for biological reasons not be representative for isolates of the same bacterial species from other sites, i.e. urinary tract infections, pneumonia, wound infections, etc. • For every patient only the first sample of the year is used in the data (per bacteria). If several samples are taken on the same day, then the sample with the least susceptible result (R>I>S) is retained. European Antimicrobial Resistance Surveillance Network (EARS-Net) Belgium, isolates from 2013 3. ABBREVIATION AMR: Antimicrobial resistance AST: Antimicrobial Susceptibility Testing CI: Confidence interval CLSI: Clinical and Laboratory Standards Institute (USA) CSF : Cerebrospinal fluid EARS-Net: European Antimicrobial Resistance Surveillance Network ECDC: European Centre for Disease Prevention and Control ENCFAI : E. faecium ENCFAE : E. faecalis ESCCOL : E. coli EUCAST: European Committee on Antimicrobial Susceptibility Testing (EU) KLEPNE : K. pneumoniae KUL : Katholieke Universiteit Leuven LIMS : Laboratory information management system MIC: Minimum inhibitory concentration PSEAER : P. aeruginosa S/I/R: Sensitive / Intermediary / Resistant STAAUR : S. aureus STRPNE: S. pneumoniae WIV-ISP : Wetenschappelijk Instituut Volksgezondheid - Institut Scientifique de Santé Publique European Antimicrobial Resistance Surveillance Network (EARS-Net) Belgium, isolates from 2013 4. ANTIMICROBIAL CODES (ECDC) Table 1 Explanation of official ECDC Antimicrobial codes Code Name Code Name Code Name ACM Acetylmidecamycin DIT Cefditoren OXA Oxacillin AMB Amphotericin B DKB Dibekacin OXO Oxolinic acid AMC Amoxicillin/Clavulanic acid DOX Doxycycline OXY Oxytetracycline AMK Amikacin ECO Econazole PAN Panipenem AMP Ampicillin ENR Enrofloxacin PAR Paromomycin AMR Amprolium ENX Enoxacin PAS P-Aminosalicylic acid AMX Amoxicillin EPE Eperozolid PEF Pefloxacin APL Apalcillin EPP Epiroprim PEN Penicillin G APR Apramycin ERY Erythromycin PIM Pentisomicin APX Aspoxicillin ETH Ethambutol PIP Piperacillin ARB Arbekacin ETI Ethionamide PIR Piromidic acid ASP Acetylspiramycin ETO Etopabat PIS Piperacillin/Sulbactam AST Astromicin ETP Ertapenem PKA Propikacin ATM Aztreonam FAR Faropenem PNO Penicillin/Novobiocin AVI Avilamycin FEP Cefepime PNV Penicillin V AVO Avoparcin FLA Flavomycin POL Polymixin B AXS Amoxicillin/Sulbactam FLC Flucloxacillin PPA Pipemidic acid AZL Azlocillin FLE Fleroxacin PRC Piridicillin AZM Azithromycin FLM Flumequine PRI Pristinamycin BAC Bacitracin FLO Flomoxef PRL Pirlimycin BAM Bacampicillin FLR Florfenicol PRM Primycin BCZ Bicozamycin FLU Fluconazole PRP Propicillin BDP Brodimo prim FMD Fosmidomycin PRX Premafloxacin BIA Biapenem FOS Fosfomycin PTH Prothionamide BUT Butoconazole FOX Cefoxitin PTZ Pentizidone CAC Cefacetrile FRM Framycetin PZA Pyrazinamide CAP Capreomycin FRZ Furazolidone QDA Quinup ristin/Dalfopristin CAR Carumonam FUS Fusidic acid RAC Ractopamine CAT Cefetamet GAT Gatifloxacin RIB Rifabutin CAZ Ceftazidime GEH Gentamicin-High RID Cefaloridin CCL Cefetecol (Cefcatacol) GEM Gemifloxacin RIF Rifampin CCP Cefcapene GEN Gentamicin ROK Rokitamycin CCV Ceftazidime/Clavulanic acid GRI Griseofulvin ROS Rosoxacin CDR Cefdinir GRX Grepafloxacin RXT Roxithromicin CDZ Cefodizime HAB Habekacin SAL Salinomycin CEC Cefaclor HAP Cephapirin SAM Ampicillin/Sulbactam CED Cephradine HET Hetacillin SAR Sarafloxacin CEM Cefteram HYG Hygromycin SBC Sulbenicillin CEP Cephalothin INH Isoniazid SDI Sulfadiazine CFB Cefbuperazone IPM Imipenem SDM Sulfadimidine CFM Cefix ime ISE Isepamicin SIS Sisomicin CFP Cefoperazone ISO Isoconazole SMX Sulfamethoxazole CFR Cefadroxil ITR Itraconazole SNA Sulfasuccinamide CFS Cefsulodin JOS Josamycin SOX Sulfisoxazole CFZ Cefpimizole KAH Kanamycin -High SPI Spiramycin CHE Cefotiam hexetil KAN Kanamycin SPT Spectinomycin CHL Chloramphenicol KET Ketoconazole SPX Sparfloxacin CIC Ciclacillin KIT Kitasamycin (Leucomycin) SRX Sarmoxicillin CID Cefonicid LAS Lasalocid SSS Sulfonamides CIN Cinoxacin LEX Cephalexin STH Streptomycin-High CIP Ciprofloxacin LIN Lincomycin STR Streptomycin CLA Clavulanic acid LNZ Linezolid SUC Sulconazole CLI Clindamycin LOM Lomefloxacin SUD Sulfadimethoxine CLO Cloxacillin LOR Loracarbef SUL Sulbactam CLR Clarithromycin LSP Linco-spectin SUM Sulfamethazine CLX Clinafloxacin LVX Levofloxacin SUP Sulfachlorpyridazine CMX Cefmenoxime MAN Cefamandole SUT Sulfathiazole CMZ Cefmetazole MCR Micromomicin SXT Trimethoprim/Sulfamethoxazole CND Ceforanide MCZ Miconazole SZO Sulfamazone CNX Cefminox MEC Mecillinam (Amdinocillin) TAZ Tazobactam European Antimicrobial Resistance Surveillance Network (EARS-Net) Belgium, isolates from 2013 Code Name Code Name Code Name COL Colistin MEL Meleumycin TBQ Tilbroquinol CPD Cefpodoxime MEM Meropenem TCC Ticarcillin/Clavulanic acid CPI Cefetamet pivoxil MES Mesulfamide TCY Tetracycline CPM Cefpiramide MET Methicillin TDC Tiodonium chloride CPO Cefpirome MEZ Mezlocillin TEC Teicoplanin CPR Cefprozil MFX Moxifloxacin TEM Temocillin CPX Ce fpodoxime proxetil MID Midecamycin TET Tetroxoprim CRB Carbenicillin MIL Miloxacin TFX Tosufloxacin CRD Cefroxadine MNO Minocycline THA Thiacetazone CRO Ceftriaxone MON Monensin sodium THI Thiamphenicol CSL Cefoperazone/Sulbacta m MOX Moxalactam (Latamoxef) TIA Tiamulin CSU Cefsumide MSU Mezlocillin/Sulbactam TIC Ticarcillin CTB Ceftibuten MTP Metioprim TIL Tilmicosin CTC Cefotaxime/Clavulanic acid MTR Metronidazole TIN Tinidazole CTE Chlortetracycline MUP Mupirocin TIO Ceftiofur CTF Cefotiam MXT Metioxate TLP Talmetoprim CTO Cetocycline NAF Nafcillin TLT Telithromycin CTR Clotrimazole NAL Nalidixic acid TMP Trimethoprim CTS Cefotaxime/Sulbactam NAR Narasin TMX Temafloxacin CTT Cefotetan NEO Neomycin TOB Tobramycin CTX Cefotaxime NET Netilmicin TRL Troleandomycin CTZ Cefatrizine NIC Nicarbazin TRO Trospectomycin CXA Cefuroxime axetil NIF Nifuroquine TVA Trovafloxacin CXM Cefuroxime sodium NIT Nitrofurantoin TXC Tioxacin CYC Cycloserine NIZ Nitrofurazone TYL Tylosin CZD Cefazedone NOR Norfloxacin TZP Piperacillin/Tazobactam CZL Cefetrizole NOV Novobiocin VAN Vancomycin CZO Cefazolin NTR Nitroxoline VIO Viomycin CZX Ceftizoxime NVA Norvancomycin VIR Virginiamycine DAP Daptomycin NYS Nystatin ZON Cefuzonam DEM Demeclocycline OFX Ofloxacin DFX Danofloxacin OLE Oleandomycin DIC Dicloxacillin OPT Optochin DIF Difloxacin ORN Ornidazole DIR Dirithromycin ORS Ormetropim/Sulfamethoxine European Antimicrobial Resistance Surveillance Network (EARS-Net) Belgium, isolates from 2013 5. SUMMARY This report covers the Belgian data (samples from 2013) for the European Antimicrobial Resistance surveillance net- work (EARS-net). Antimicrobial susceptibility profiles of 7 bacterial species ( S. aureus , S. pneumoniae , E. faecium, E. faecalis, E. coli, K. pneumoniae, P. aeruginosa ) retrieved from blood cultures and cerebrospinal fluid for a selection of antimicrobial agents are provided. Additional information is given to the potential for error and bias, as well as background on the
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