UCSF Benioff Children's Hospital Antimicrobial Susceptibility Gram-positives Inpatients/ED 2014-2016

PrintPrintPDFPDF

N/A - testing NOT APPLICABLE to organism. PCN - penicillin, NAF - nafcillin, ERY - erythromycin, CLIN - clindamycin, CIP - ciprofloxacin, DOX - doxycycline, T/S - trimethoprim/sulfamethoxazole, VANC - vancomycin

Values are % of isolates testing susceptible to listed antibiotic. Unless indicated, results are for all inpatient/ED locations and culture sites. 

For all organisms, the number of isolates and susceptibilities are based on combined data from 2014-2016. Isolate numbers and 95% confidence intervals are provided to guage precision of susceptibility estimates. 

Organism

Total

Isolates

PCN

 

NAF

%S

(95% CI)

ERY

%S 

(95% CI)

CLIN

%S 

(95% CI)

CIP

%S

(95% CI)

DOX

%S

(95% CI)

T/S

%S

(95% CI)

VANC

%S

Staphylococcus aureus*

344

N/A

78

(73, 82)

63

(57,68)

84

(80,88)

82

(77,86)

95

(92,97)

98

(95,99)

100

MRSA

76

N/A

N/A

18

(10,29)

84

(74,92)

43

(32,55)

95

(87,99)

99

(93,100)

100

MSSA

268

N/A

100

75

(69,80)

84

(79,88)

93

(89,95)

95

(91,97)

97

(95,99)

100

Staphylococcus epidermidis

84

N/A

31

(21,42)

7

(2,15)

65

(54,76)

67

(56,77)

88

(79,94)

63

(52,73)

100

Streptococcus pneumoniae

46*

See below

N/A

80

(66,91)

87

(66,97)

N/A

78

(64,89)

87

(66,97)

100

 *Streptococcus pneumoniae inpatient, ED and outpatient isolates combined - only 23 had full susceptibility testing - estimates for clindamycin and TMP-SMX based on 23 isolates - may not reflect robust estimate of population susceptibility

Enterococcus spp.

Enterococcus faecalis species are 100% AMP susceptible. Enterococcus faecium can be multi-drug resistant. Check vancomycin susceptibilities for all isolates from sterile sites. Of 42 enterococcal bacteremias in 2014-2016, 3 were vancomycin-resistant Enterococcus faecium, 4 were Enterococcus species considered functionally resistant to vancomycin, but susceptible to ampicillin.


Streptococcus pneumoniae

Across 23 isolates with full susceptibility testing (<30 isolates therefore may not represent robust susceptibility profile):

  • 91% (95% CI 72,99) were penicillin-susceptible by non-meningitis breakpoint (MIC <=2)
  • 43% (95% CI 23,66) were penicillin-susceptible by meningitis breakpoint (MIC <=0.06)
  • 87% (95% CI 66,97) were ceftriaxone-susceptible by non-meningitis breakpoint (MIC <=1)
  • 74% (95% CI 52,90) were ceftriaxone-susceptible by meningitis breakpoint (MIC <=0.05)

NOTE: For empiric treatment of meningitis in the non-neonate, pending susceptibilities, vancomycin should be added to the regimen since failures (due to highly resistant isolates) have been reported with ALL third generation cephalosporins.