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Australian Group on Antimicrobial Resistance (AGAR) Australian Gram-negative Sepsis Outcome Programme (GNSOP) Annual

Jan M Bell1, Thomas Gottlieb2, Denise A Daley3

  • 1University of Adelaide, Adelaide, South Australia, Australia.

Communicable Diseases Intelligence (2018)
|January 11, 2019
PubMed

Insights

The Australian Group on Antimicrobial Resistance (AGAR) 2016 study tracked resistance in Gram-negative pathogens. Key findings show concerning non-susceptibility rates to common antibiotics like ceftriaxone and ciprofloxacin.

Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance Surveillance

Background:

  • The Australian Group on Antimicrobial Resistance (AGAR) conducts periodic surveys to monitor antimicrobial resistance trends.
  • Antimicrobial resistance in Gram-negative pathogens poses a significant global health threat, necessitating continuous monitoring.
  • Bloodstream infections caused by Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter species are common and can lead to severe outcomes.

Purpose of the Study:

  • To report the findings of the 2016 AGAR period-prevalence study on antimicrobial resistance in selected Gram-negative pathogens.
  • To assess resistance patterns to key antibiotics, including third-generation cephalosporins, fluoroquinolones, and beta-lactam/beta-lactamase inhibitors.
  • To identify the prevalence of carbapenemase genes in the studied bacterial isolates.

Main Methods:

  • Analysis of 7,565 bacterial isolates from bloodstream infections, including Enterobacteriaceae, P. aeruginosa, and Acinetobacter species.
  • Utilized commercial automated methods (Vitek 2, Phoenix) for antimicrobial susceptibility testing.
  • Interpreted results using Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints.

Main Results:

  • Non-susceptibility to ceftriaxone was observed in 11.8% of Escherichia coli and 7.7% of Klebsiella pneumoniae.
  • Ciprofloxacin non-susceptibility rates varied, with E. coli at 12.8%/16.3% and P. aeruginosa at 5.5%/9.4% (CLSI/EUCAST).
  • Twenty-eight isolates harbored carbapenemase genes, including blaIMP, blaOXA-23, blaNDM, and others.

Conclusions:

  • The 2016 AGAR study highlights ongoing challenges with antimicrobial resistance in common Gram-negative pathogens in Australia.
  • Monitoring resistance to critical antibiotics like ceftriaxone and ciprofloxacin is essential for guiding treatment strategies.
  • The presence of carbapenemase genes underscores the need for enhanced surveillance and infection control measures.

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