New GLA antibiogram from 2018

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.