Category Pathology North

2016 Hunter New England LHD Cumulative Antibiograms just released

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 each report. These are prepared by Pathology North, Microbiology for Hunter, New England and Lower Mid-north coast regions. The antibiogram reports include analyses of […]

Pathology stewardship – an essential element of AMS

Poor antimicrobial prescribing decisions often are triggered by laboratory results that create red herrings or worse.  Inappropriate/ poor specimen collection and/or a request form that provides no context to the investigation often sets the ball rolling.  Inappropriate workup and reporting of contaminant or colonising isolates may then follow (it may be impossible for the lab […]

Micro lab comments: candidaemia and candiduria

Candidal bloodstream infection represents a high risk infection, even for immunocompetent patients. Mortality is significant even for IV line-associated candidaemia.  Blood cultures are seldom contaminated by fungi and any patient with an isolate must be subjected to careful clinical assessment. Our comment serves to give a few reminders that follow on from the liaison between the […]

Hunter New England Cumulative Antibiogram Updates reflecting 2015 isolate data

Hot of the press – our updated antibiograms with commentaries – revised format. Some take home messages from these analyses: Gentamicin retains excellent coverage of aerobic Gram negative bacteria and remains the best choice for empirical Gram negative cover, as reflected in the Australian Therapeutic Guidelines: Antibiotic recommendations. The proportion of non-urinary isolates of Staph. aureus […]

Micro comments: Clostridium difficile testing

Here are our local Pathology North (NSW) comments together with their rationale: Positive CDI test result comment (no test of clearance required!): The duration of contact precautions following recovery are controversial. Patients will continue to excrete C. difficile for weeks following recovery and can represent a cross infection risk. However continent patients with formed stool who […]

Microlab comment: beta-haemolytic streptococci isolated from blood

Here is another one used for uncomplicated bloodstream infection events: Infections due to these species of streptococci are usually rapidly responsive to appropriate antibiotic therapy which can be of short duration with no minimum IV requirement as endocarditis is not a usual consideration.  Penicillin resistance has not been documented and flucloxacillin is just as active (see […]

Micro comments unpacked: Gram negative bacteraemia

Here is an example comment from Pathology North which is added to positive blood culture reports when a Gram negative coliform species ( Enterobacteriacae eg. E. coli) has been isolated: The comment’s rationale is to promote short course treatment and also to prompt oral antibiotic switching in a timely manner.  It also prompts consideration of source […]

Maximising the value of blood cultures

Blood cultures give a critically important window on bacterial and fungal sepsis, providing direct patient treatment guidance and reliable antimicrobial susceptibility data that are used to construct cumulative antibiograms and empirical treatment guidelines.  They also help to rule out serious bacterial infection, provided that collection occurs prior to antibiotic treatment and an adequate patient sample is taken. Here […]

What are cumulative antibiograms ?

Antibiograms summarise local antimicrobial susceptibility in order to guide appropriate antimicrobial prescribing. Ideally they are updated annually by microbiology services to provide a current  picture of bacterial susceptibility and the local incidence of key sentinel resistant pathogens.

Australian National Antimicrobial Resistance Strategy: Objective Seven, Governance- What does it mean for HNE?

The final objective Seven of the Australian strategy focuses on strengthening AMS governance at local, regional and national levels to ensure leadership, engagement and accountability for actions taken to combat antimicrobial resistance. A coordinated effort from a wide range of participants is required.  Engaging participants at the frontline of antibiotic prescribing will be an important step in meeting these objectives. Priority […]