isolates-2015-blood-105.html
DANMAP 2015 3D
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danmap 2015 106
resistance
in human clinical bacteria 8. the years to come, a more stringent surveillance will be pos- sible, independent of local interpreting rules that make sense in the clinical situation for treatment of a specific infection but are not harmonized for national surveillance purposes. one carbapenem (meropenem) resistant and five intermedi- ary resistant e.
coli
blood
isolates
were reported in 2015. in 2014, there were none carbapenem resistant e.
coli
blood
isolates
. this might reflect the general and worrisome increase in carbapenem resistant enterobacteriacae observed in 2015 commented in textbox 8.2. in the 10-year period from 2006 to 2015,
resistance
in e.
coli
blood
isolates
has altogether increased steadily, the increase being most pronounced from 2006 to 2011, since showing a slight stagnation for most antibiotics. for ciprofloxacin a decrease is observed from its peak of 14%
resistance
in 2009 to 2012, to 12%
resistance
in 2015, but still far from the 7%
resistance
in 2006. this development parallels the trends in total antimicrobial consumption, which showed pronounced increase until 2010 with a peak of 19.25 did and since a slow decrease to a total of 18,50 did in 2015 giving a drop in total consumption of 0.75 did (figure 5.1).
resistance
to piperacil- lin/tazobactam has been surveilled since 2009. in this 7-year period a rather constant
resistance
profile has been observed, with 4.7%
resistance
in 2009, dropping to 4.0%
resistance
in 2010 to 2013 and then moving back up to 5 %
resistance
in 2014 and 2015. the trend for piperacillin/tazobactam is observed closely since changes in the consumption owing to a shift from cefuroxime as most used antibiotic in the treat- ment of e.
coli
infections and sepsis in hospitalized patients to piperacillin/tazobactam have resulted in an increase of the consumption of piperacillin/tazobactam in danish hospitals from 2008 and onward (figure 5.11). urine
isolates
from hospital patients danmap received data on 46,723 e.
coli
isolates
from urine in hospitalized patients. not all dcm tested for all antibiotics reported here. (table 8.1 and figure 8.2) for at least 82% of
isolates
all 11 dcm reported data on mecillinam and ciprofloxacin susceptibility, while 10 dcm reported data on ampicillin, gentamycin and cefuroxime susceptibility. data on piperacillin/tazobactam, 3rd generation cephalosporins and meropenem susceptibility was reported by 8 dcm and sulfamethizole susceptibility was reported by 7 dcm. there was a slight but significant increase in
resistance
to me- cillinam, piperacillin/tazobactam and cefuroxime from 7.2% to 7.7%, 3.5% to 3.9% and 6.6% to 7.0% respectively compared to 2014. in 2015, three carbapenem (meropenem) resistant and 11 intermediary resistant e.
coli
isolates
from hospital urine were reported. for comparison, there was none meropenem resis- tant and one meropenem intermediary resistant e.
coli
isolate from hospital urine in 2014. as already mentioned there was a worrisome increase in carbapenem
resistance
in general among gram negative pathogens in 2015, which is addressed further in textbox 8.2. urine
isolates
from primary health care danmap received data on 61,073 e.
coli
isolates
from urine from patients in primary health care. in denmark culturing and susceptibility testing of urines from primary health care varies substantially between the different regions. many gp´s perform local testing and thus primarily urines from patients with known
resistance
problems are sent to the dcm at the regional hospital. other gp´s use their local table 8.1.
resistance
(%) in escherichia
coli
isolates
from humans, denmark substance blood
isolates
, hospitals % urine
isolates
, hospitals % urine
isolates
, primary health care % ampicillin 45 42 39 # mecillinam 10 b) 8 * 5 piperacillin/tazobactam 5 4 * 4 sulfonamide 32 31 # gentamicin 7 5 4 ciprofloxacin 12 11 9 cefuroxime 9 7 * 5 3rd generation cephalosporins a) 7 6 4 meropenem <1 <1 <1 max. number of
isolates
tested 4595 46572 61047 * ) an asterisk indicates a significant increase from 2014 to 2015 #) a number sign indicates a significant decrease from 2014 to 2015 a) tested 3rd generation cephalosporins were ceftazidime, ceftriaxone, cefpodoxime and cefotaxime b) mecillinam
resistance
from blood
isolates
is repported without data from skejby as in 2014 but no significance testing have been done danmap 2015
2015-coli-isolates-107.html
