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LPCH Data From 2013 Isolates

Gram Negative Bacilli (a)

Values expressed are % susceptible

  PenicillinsCephalosporinsAminoglyc'sLactamsOthersUrines Only
 

No. of Isolates9
(a)

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
Achromobacter xylosoxidans16(b,c)-100---816000091694--
Acinetobacter baumannii8 (b,c)-----7588100100100-10088100--
Citrobacter freundii complex42 (c)0760086861001009391641009160093
Enterobacter aerogenes28 (b,c)01000067751001001001007610010093-0
Enterobacter cloacae complex670550054551001009797561009573041
Escherichia coli4034693838592959810090929210087624693
Klebsiella oxytoca30083-81839310010093938910093906389
Klebsiella pneumoniae6709470809193979692949310097728021
Morganella morganii11 (b,c)0-0080100--80100--8282--
Proteus mirabilis328196-92941009410088901001009169950
Pseudomonas aeruginosa142 (d)-92---8078888296738985---
Pseudomonas aeruginosa (CF-mucoid) (e)40 (c,d)-Pip 93-Imp 78-9390--78839083---
Pseudomonas aeruginosa (CF-non-mucoid) (e)148 (d)-Pip 89-Imp 83-9189--84778782---
Salmonella spp.30 (c)83---80-------6797--
Serratia marcescens51 (c)093009810010010092%921001009898-0
Stenotrophomonas maltophilia51-------Levo 90----96--
  • Pip = Piperacillin; Imp = Imipenem; Levo = Levofloxacin
  • (a) First isolate from each patient was included
  • (b) Data from isolate totals <30 may be statistically unreliable
  • (c) Includes isolates from 2012
  • (d) Pseudomonas aeruginosa isolates not corrected for duplicates
  • (e) Cystic fibrosis patient isolates tested by disk diffusion

Gram Positive Cocci

Values expressed are % susceptible

  Beta-LactamsOthers
 Number of IsolatesOxa-
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             
Staphylococcus aureus42482(b)--82---95-7253-99100--
  MRSA only15200--0---94-5914-10010095-
Staphylococcus lugdunensis7 (c,d)100(b)--100---100-100100-100100--
Staphylococcus sp., Coagulase-negative8431(b)--31---63-5121-60100--
Enterococcus faecium7 (c,d)-14086----------14-100
Enterococcus faecalis24 (c,d)-9604----------100--
Enterococcus sp. (not identified to species)134-9604-----83--95-96--
Streptococcus group B (vag/anal screen)234-10000------72------
viridans group streptococci34-79156--88---8262--100--
Streptococcus pneumoniae32-81(e)-19-8497(f)91--8984-84100--
  • (a) Testing for inducible clindamycin resistance performed on all staphylococci and group B strep isolates
  • (b) Sensitivity confirmed by PCR per request
  • (c) Data from isolate totals <30 may be statistically unreliable
  • (d) Includes isolates from 2012
  • (e) Based on meningitis interpretive criteria (more conservative). Nonmeningitis
    interpretation is 100%
  • (f) Ceftriaxone uses the meningitis interpretive criteria (more conservative)

Candida

 Percent Susceptible By Broth Microdilution (YeastOne, Trek Diagnostics)No. TestedAmphotericin B
($$$$)
Fluconazole
($)
Itraconazole
($)
Voriconazol
($$$$)
Caspofungin (a)
($$$)
Candida albicans23100969696100
Candida glabrata6 (d,e)10000100100
Candida parapsilosis9 (d, e)100100100100100
Other Candida species12 (d,e)100(f)67100100
  • (a) Suggested Ampho Resistant breakpoint MIC > or = 2 mcg/ml.
  • (b) Susceptibe dose-dependend breakpoint MIC was used
  • (c) Consult Peds ID if Caspofungin being considered for treatment
  • (d) Data from isolate totals <30 may be statistically unreliable
  • (e) Includes isolates from 2012
  • (f) Species other than C. krusei are 100% susceptible; C. krusei is intrinsically resistant to fluconazole

 

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, 79% (61/77) of H. influenzae are ampicillin susceptible.

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