LPCH Data From 2012 Isolates
Gram Negative Bacilli (a)
Values expressed are % susceptible
| Penicillins | Cephalosporins | Aminoglyc's | Lactams | Others | Urines Only | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of Isolates | Ampi- cillin |
Piper/ Tazo- bactam |
Cefaz- olin Urines only |
Cefur- oxime (IV) |
Ceftri- axone |
Ceft- azidime |
Cefe- pime |
Ami- kacin |
Genta- micin |
Tobra- mycin |
Aztreo- nam |
Mero- penem |
Cipro- flox- acin |
Co-tri- moxa- zole |
1st gener- ation Cephems |
Nitro- furan- toin |
|
| Cost | $ | $$$ | $ | $ | $ | $ | $ | $$$ | $$$ | $$$ | $$$ | $$$ | $ | $ | $ | $$$ | |
| Achromobacter xylosoxidans | 12 | - | 100% | - | - | - | 83% | 12% | 0% | 0% | 0% | 0% | 88% | 0% | 88% | - | - |
| Acinetobacter baumannii | 7 (b) | - | - | - | - | - | 86% | 100% | 100% | 100% | 100% | 0% | 100% | 86% | 86% | - | - |
| Citrobacter freundii | 21 | 0% | 60% | 0% | 0% | 71% | 71% | 100% | 100% | 86% | 79% | 75% | 100% | 86% | 57% | 0% | 100% |
| Enterobacter aerogenes | 15 | 0% | 100% | 0% | 0% | 69% | 69% | 100% | 100% | 100% | 100% | 69% | 100% | 100% | 100% | - | 0% |
| Enterobacter cloacae | 64 | 0% | 83% | 0% | 0% | 73% | 78% | 100% | 100% | 97% | 97% | 77% | 100% | 100% | 88% | 0% | 49% |
| Escherichia coli | 330 | 48% | 98% | 92% | 88% | 95% | 97% | 98% | 99% | 92% | 92% | 95% | 99% | 90% | 65% | 59% | 95% |
| Klebsiella oxytoca | 25 | 0% | 93% | - | 88% | 96% | 100% | 100% | 100% | 100% | 100% | 96% | 100% | 100% | 96% | 78% | 90% |
| Klebsiella pneumoniae | 58 | 0% | 88% | 100% | 86% | 93% | 93% | 97% | 97% | 95% | 95% | 91% | 97% | 97% | 81% | 96% | 12% |
| Morganella morganii | 6 (b) | 0% | - | 0% | 0% | 100% | 100% | - | - | 100% | 100% | - | - | 100% | 83% | - | - |
| Proteus mirabilis | 30 | 70% | 100% | - | 91% | 93% | 100% | 100% | 100% | 80% | 80% | 100% | 100% | 90% | 73% | 86% | 0% |
| Pseudomonas aeruginosa | 71 | - | 87% | - | - | - | 87% | 87% | 96% | 90% | 99% | 77% | 92% | 97% | - | - | - |
| Pseudomonas aeruginosa (CF-mucoid) (c) | 58 (d) | - | Pip 88% | - | Imp 74% | - | 86% | 76% | - | - | 74% | 79% | 88% | 83% | - | - | - |
| Pseudomonas aeruginosa (CF-non-mucoid) (c) | 153 (d) | - | Pip 88% | - | Imp 83% | - | 88% | 84% | - | - | 85% | 76% | 89% | 80% | - | - | - |
| Salmonella spp. | 7(b) | 71% | - | - | - | 71% | - | - | - | - | - | - | - | 57% | 86% | - | - |
| Serratia marcescens | 24 | 0% | 89% | 0% | 0% | 100% | 100% | 100% | 95% | 92% | 79% | 100% | 100% | 96% | 92% | - | 0% |
| Stenotrophomonas maltophilia | 40 | - | - | - | - | - | - | - | Levo 90% | - | - | - | - | 95% | - | - | |
- Pip = Piperacillin; Imp = Imipenem; Tic/Clav = Ticarcillin/Clavulanate; Levo = Levofloxacin
- (a) Not all isolates tested against every antibiotic
- (b) Data from isolate totals <10 may be statistically unreliable
- (c) Cystic fibrosis patient isolates tested by disk diffusion
- (d) Pseudomonas aeruginosa isolates not corrected for duplicates
Gram Positive Cocci
Values expressed are % susceptible
| Beta-Lactams | Others | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of Isolates | Oxa- cilli/ Naf- cillin |
Penicillin or Ampicillin | 1st Gener- ation cephems |
Cefur- oxime |
Ceftri- axone |
Mero- penem |
Genta- micin |
Cipro- floxacin |
Clinda- mycin (a) |
Erythro- mycin |
Nitro- furantoin - urine |
Co-trimox- azole |
Vanco- mycin |
Tetra- cycline |
Line- zolid |
|||
| %S | %I | %R | ||||||||||||||||
| Cost | $$ | $ | $ | $ | $ | $$$ | $$$ | $ | $ | $$ | $$$ | $ | $$ | $ | $$$$ | |||
| Staphylococcus aureus | 309 | 79% | 15% (b) | - | - | 79% | - | - | - | 96% | - | 71% | 53% | - | 99% | 100% | - | - |
| MRSA only | 65 | 0% | 0% | - | - | 0% | - | - | - | 92% | - | 46% | 8% | - | 97% | 100% | 92% | - |
| Staphylococcus lugdunensis | 3 (c) | 100% | 33% | - | - | 100% | - | - | - | 100% | - | 100% | 100% | - | 100% | 100% | - | - |
| Staphylococcus sp., Coagulase-negative | 72 | 36% | 11% | - | - | 36% | - | - | - | 69% | - | 56% | 32% | - | 79% | 100% | - | - |
| Enterococcus faecium | 2 (c) | - | 0% | 0% | 100% | - | - | - | - | - | - | - | - | - | - | 0% | - | 100% |
| Enterococcus faecalis | 13 | - | 100% | 0% | 0% | - | - | - | - | - | - | - | - | - | - | 100% | - | - |
| Enterococcus sp. (not identified to species) | 151 | - | 92% | 0% | 8% | - | - | - | - | - | 83% | - | - | 93% | - | 97% | - | - |
| Streptococcus group B (vag/anal screen) | 310 | - | 100% | 0% | 0% | - | - | - | - | - | - | 73% | 70% | - | - | - | - | - |
| viridans group streptococci | 31 | - | 52% | 29% | 19% | - | - | 95% | - | - | - | 78% | 56% | - | - | 100% | - | - |
| Streptococcus pneumoniae | 31 | - | 52% (d) | - | 48% | - | 69% | 87% (e) | 64% | - | - | 76% | 60% | - | 57% | 100% | - | - |
- (a) Testing for inducible clindamycin resistance performed on all staphylococci and group B strep isolates.
- (b) β-lactamase sensitivity confirmed by PCR.
- (c) Data from isolate totals <10 may be statistically unreliable.
- (d) Based on meningitis interpretive criteria (more conservative). Nonmeningitis interpretation is 100%.
- (e) Ceftriaxone uses the meningitis interpretive criteria (more conservative).
Candida
| Percent Susceptible By Broth Microdilution (YeastOne, Trek Diagnostics) | No. Tested | Amphotericin B | Fluconazole | Itraconazole | Voriconazole | Caspofungin (a) |
|---|---|---|---|---|---|---|
| Cost | $$$$ | $ | $ | $$$$ | $$$ | |
| Candida albicans | 11 | 100% | 91% | 91% | 100% | 100% |
| Candida glabrata | 0 | - | - | - | - | - |
| Candida parapsilosis | 5(b) | 100% | 100% | 100% | 100% | 100% |
| Other Candida species | 5(b) | 100% | (c) | 100% | 100% | 100% |
Haemophilus influenzae
|
For infections with beta-lactamase producing H. influenzae: cefuroxime, cefotaxime, trimethoprim/sulfamethoxazole, amoxicillin/clavulanate, or azithromycin is recommended. Cefotaxime or ceftriaxone is drug of choice for CNS infections. At LPCH, 77% (37/48) of H. influenzae are ampicillin susceptible. |
- (a) Consult Peds ID if Caspofungin being considered for treatment.
- (b) Data from isolate totals <10 may be statistically unreliable.
- (c) Species other than C. krusei are 100% susceptible; C. krusei is intrinsically resistant to fluconazole.
Drug cost:
Please chose the appropriate antibiotic based on best spectrum of coverage and lowest cost.
Costs are reflective of 1 day
of therapy based on adult dosing and include drug
levels and reformulations.
$ = $0-20
$$ = $20-50
$$$ = $50-100
$$$$ => $100
Clinical Microbiology
- Niaz Banaei, MD, Director
- Nancy Watz CLS, Laboratory Reference Technologist, Antibiotics
- Diane Getsinger, CLS, Laboratory Reference Technologist, AFB/Mycology
- Kathleen Gutierrez, MD, Integrated Pediatric Infectious Diseases Program Committee Committee Chair
Reference
- Stanford Test Directory
- Stanford CRL Online Onsite at SUMC ONLY
- Micromedex
- Pocket Guide to Dx Tests: Microbiology
