New GLA antibiogram from 2018

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Our 2018 antibiogram, which compiles antimicrobial resistance data from GLA isolates from the calendar year 2018 is now available here.  Overall resistance patterns are largely stable compared to 2017 with a few caveats (see below). 

For Gram-negative rods in the hospital setting:

  • Amikacin resistance remains very low and so is still the most active agent vs. multi-drug resistant Gram-negative rod infections at GLA.

  • Carbapenem-resistant Enterobacteriaceae remain somewhat uncommon at GLA.

  • There is not much overall difference between piperacillin-tazobactam, cefepime, and meropenem for most Enterobacteriaceae and Pseudomonas (all are better than fluoroquinolones), though there has been a slight decrease in susceptibility to cefepime among all nosocomial non-urine isolates.  Please note that >30% nosocomial Pseudomonas isolates are resistant to meropenem.

  • Ceftriaxone resistance is increasing among all nosocomial E. coli isolates (non-urine: 47% vs. 19% from 2017; urine: 36% vs. 26% from 2017)

  • Pseudomonas is less frequently encountered in the urine as compared to other sites.

For Gram-negative rods in the outpatient setting:

  • While cephalexin and cefadroxil remain first-line options for outpatient UTI treatment at GLA, our outpatient E. coli urinary isolate cefazolin susceptibility has decreased to 77% according to breakpoints established for serum (was 92% in 2017).  We are in the process of determining susceptibility according to breakpoints established for urine (which are much higher).

  • Fluoroquinolones and TMP-SMX susceptibilities remain similar (~75-80%).

Key trends among Gram-positive isolates:

  • MRSA remains quite common (~60% of nosocomial non-blood isolates, ~30% of nosocomial blood isolates, and ~40% of outpatient isolates).

  • Doxycycline resistance decreased among non-blood nosocomial S. aureus isolates (19% vs. 30%) from 2017.