Uropathogen antibiogram regional variations-Are Australian antimicrobial guidelines appropriate?

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Antimicrobial Stewardship

Background:

• Antimicrobial resistance is a growing global health concern.
• Uropathogen antibiograms are essential for guiding empirical treatment of urinary tract infections and preventing surgical site infections.
• National guidelines may not reflect local resistance patterns.

Purpose of the Study:

• To compare uropathogen antibiograms and antimicrobial susceptibility patterns between two tertiary hospitals in Victoria.
• To evaluate the applicability of national guideline recommendations for local clinical practice.
• To assess the feasibility of local antibiogram analysis for developing hospital-specific treatment guidelines.

Main Methods:

• Retrospective analysis of all positive urine cultures from Barwon Health and Monash Health (January 2019 - December 2020).
• Data collection included organism identification and antimicrobial susceptibility profiling.
• Comparison of susceptibility patterns between the two hospitals.

Main Results:

• Over 10,000 positive urine cultures were analyzed.
• Escherichia coli was the most common uropathogen at both sites.
• Significant differences in susceptibility were observed for Enterococcus spp., Candida spp., and resistance to fluoroquinolones and vancomycin between the hospitals.

Conclusions:

• Considerable variability exists in uropathogen types and antimicrobial susceptibility profiles between the two Victorian health services.
• Regular local antibiogram analysis is recommended to inform the development of tailored treatment and prophylaxis guidelines.
• Hospital-specific guidelines are necessary to optimize antimicrobial use and combat resistance.