Cumulative antibiograms provide a summary of current bacterial antimicrobial susceptibility for key pathogens in urine and non-urine specimens.  Treatment recommendations based on Therapeutic Guidelines, Antibiotic, Edition 15, 2014 are included in the commentaries. These are prepared by Pathology North, Microbiology for Hunter, New England, Northern NSW and Lower Mid-north coast regions. The detailed antibiogram reports are here:

• Hunter New England LHD antibiograms
• Mid North Coast LHD
• Northern NSW LHD

Recent antimicrobial resistance trends

Gram negative gentamicin susceptibility remains high (93-96% susceptible) across all sites. This agent remains the best empirical Gram negative agent for severe sepsis patients who have no contraindications.

Gram negative quinolone (ciprofloxacin) susceptibility is declining slowly (87-94% susceptible). It is important to conserve this agent as much as possible by avoiding its use when the isolate tests susceptible to a first line agent.

Gram negative ceftriaxone resistance detects the presence of an extended betalactamase (ESBL) – producing organism. The incidence of ESBL from initial isolates remained low at all sites (91-96% susceptible; Mid North-Coast at 89%).

Incidence of methicillin resistance for Staphylococcus aureus (i.e. MRSA) varied from 16-21% across the sites. High susceptibility levels are retained for doxycycline and  sulphamethoxazole+trimethoprim across all S. aureus strains, including MRSA. For individual cases, always check the actual susceptibility result if oral therapy is planned. Clindamycin susceptibility (usually tested as erythromycin) for MRSA was lower than for other agents (63-86%).

The proportion of community acquired Staphylococcus aureus bloodstream (SAB) infections that were due to MRSA was 8.9% (varying from 7.1% (Hunter Sector) to 15.4% (Tablelands Sector). For healthcare associated SAB, 13.5% of 74 events across Hunter New England Health were due to MRSA. A separate SAB report will be available on the HNE Intranet. SAB data from Mid North Coast and Northern NSW are also available via the Infection Prevention Service.