Antimicrobial susceptibility of the pathogens of bacteraemia in the UK and Ireland 2001-2002: The BSAC bacteraemia resistance surveillance programme

Rosy Reynolds*, Nicola Potz, Melissa Colman, Andrea Williams, David Livermore, Alasdair MacGowan, M. Allen, D. F.J. Brown, N. Deaney, I. Harding, V. Reed, C. Thomson, G. Thorne, A. White, R. Wiltshire, R. Wise, Robert George

*Corresponding author for this work

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131 Citations (Scopus)

Abstract

Objectives: To describe the current patterns of antimicrobial resistance in the major pathogens of bacteraemia in the UK and Ireland, to highlight any unexpected resistance patterns and to act as a reference baseline for future studies. Methods: In 2001 and 2002, 5092 blood culture isolates were collected by 29 laboratories distributed across the UK and Ireland. A single central laboratory re-identified the isolates and measured MICs by the BSAC agar dilution method. Results: Oxacillin resistance was found in 42% of Staphylococcus aureus and 76% of coagulase-negative staphylococci. Streptococci were generally susceptible to β-lactams, but tetracycline resistance was common (except in Streptococcus pneumoniae) and particularly common among group B isolates (82% resistant). Nine percent of S. pneumoniae had reduced susceptibility to penicillin (MICs 0.12-1 mg/L), but none required ≥2 mg/L for inhibition. High-level gentamicin resistance was seen in 43% of Enterococcus faecalis, often in combination with raised ciprofloxacin MICs (≥32 mg/L), but these isolates remained susceptible to ampicillin and imipenem. Only linezolid and tigecycline showed in vitro potency against a large proportion of Enterococcus faecium. Vancomycin resistance was restricted to enterococci (20% of E. faecium, 3% of E. faecalis) and a single isolate of coagulase-negative staphylococci (0.2%, MIC of 8 mg/L). Escherichia coli isolates were commonly resistant to amoxicillin (56%) and tetracycline (88%) but remained susceptible to ceftazidime, piperacillin/tazobactam and imipenem. Extended-spectrum β-lactamases were detected in 2% of E. coli (none in 2001, 3.2% in 2002), 5% of Klebsiella spp. and 8% of Enterobacter spp. Resistance rates of Pseudomonas aeruginosa to ciprofloxacin, ceftazidime, gentamicin, imipenem and piperacillin/tazobactam were between 4% and 7%. Among the newly licensed and developmental agents, there was no resistance to linezolid in Gram-positive organisms. Ertapenem had a wide spectrum, covering Enterobacteriaceae, streptococci and oxacillin-susceptible staphylococci. MICs of tigecycline were low for Gram-positive species and Enterobacteriaceae except Proteeae and Enterobacter spp. Conclusion: Antimicrobial resistance among major bloodstream pathogens to those antimicrobials often selected for empirical therapy was relatively uncommon in 2001-2002, usually <10%. An important exception was oxacillin resistance in S. aureus.

Original languageEnglish
Pages (from-to)1018-1032
Number of pages15
JournalJournal of Antimicrobial Chemotherapy
Volume53
Issue number6
DOIs
Publication statusPublished - Jun 2004

Bibliographical note

Funding Information:
Supporters and sponsors: the BSAC Bacteraemia Resistance Surveillance Programme 2001–2002 was supported by the British Society for Antimicrobial Chemotherapy and sponsored by Merck, Sharp & Dohme, Pfizer and Wyeth.

Keywords

  • Antibacterials
  • Bloodstream infections
  • British isles
  • Resistance epidemiology

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