Comparison of hospital-wide and age and location - stratified antibiograms of S. aureus, E. coli, and S. pneumoniae

Age- and location-stratified antibiograms

Sanjeev K. Swami, Ritu Banerjee

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Antibiograms created by aggregating hospital-wide susceptibility data from diverse patients can be misleading. To demonstrate the utility of age- and location-stratified antibiograms, we compared stratified antibiograms for three common bacterial pathogens, E. coli, S. aureus, and S. pneumoniae. We created stratified antibiograms based on patient age (<18 years, 18-64 years, >/=65 years), and inpatient or outpatient location using all 2009 E. coli and S. aureus, and all 2008-2009 S. pneumoniae isolates submitted to our clinical microbiology laboratory. We compared susceptibility rates among cumulative and stratified antibiograms using descriptive statistics. Findings: For E. coli and S. aureus, the institution-wide antibiogram overestimated resistance in pediatic isolates and underestimated resistance in isolates from the elderly. For E. coli, pediatric isolates were less susceptible to ampicillin and ampicillin-sulbactam and more susceptible to gentamicin and ciprofloxacin compared to adult isolates (p < 0.05 for all), and isolates from patients >65 years were least susceptible to ciprofloxacin (71%). For S. aureus, susceptibility to oxacillin, clindamycin, and levofloxacin was highest among children and decreased with increasing age (p <.001 for all). For S. pneumoniae, pediatric isolates were less susceptible than adult isolates to all agents except penicillin (IV breakpoint). Within children there were significant differences in susceptibility of inpatient and outpatient isolates of E. coli but not of S. aureus or S. pneumoniae. Conclusions: Stratified antibiograms reveal age - associated differences in susceptibility of E. coli, S. aureus, and S. pneumoniae that are obscured by hospital-wide antibiograms. Age-stratified antibiograms have potential to influence antibiotic selection.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalSpringerPlus
Volume2
Issue number1
DOIs
StatePublished - 2013

Fingerprint

Microbial Sensitivity Tests
Pneumonia
Escherichia coli
Ciprofloxacin
Inpatients
Outpatients
Pediatrics
Oxacillin
Levofloxacin
Clindamycin
Ampicillin
Microbiology
Gentamicins
Penicillins
Anti-Bacterial Agents

Keywords

  • Age-stratified
  • Antibiogram
  • Aureus
  • Coli
  • E
  • Pneumoniae
  • S

ASJC Scopus subject areas

  • General

Cite this

Comparison of hospital-wide and age and location - stratified antibiograms of S. aureus, E. coli, and S. pneumoniae : Age- and location-stratified antibiograms. / Swami, Sanjeev K.; Banerjee, Ritu.

In: SpringerPlus, Vol. 2, No. 1, 2013, p. 1-5.

Research output: Contribution to journalArticle

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abstract = "Background: Antibiograms created by aggregating hospital-wide susceptibility data from diverse patients can be misleading. To demonstrate the utility of age- and location-stratified antibiograms, we compared stratified antibiograms for three common bacterial pathogens, E. coli, S. aureus, and S. pneumoniae. We created stratified antibiograms based on patient age (<18 years, 18-64 years, >/=65 years), and inpatient or outpatient location using all 2009 E. coli and S. aureus, and all 2008-2009 S. pneumoniae isolates submitted to our clinical microbiology laboratory. We compared susceptibility rates among cumulative and stratified antibiograms using descriptive statistics. Findings: For E. coli and S. aureus, the institution-wide antibiogram overestimated resistance in pediatic isolates and underestimated resistance in isolates from the elderly. For E. coli, pediatric isolates were less susceptible to ampicillin and ampicillin-sulbactam and more susceptible to gentamicin and ciprofloxacin compared to adult isolates (p < 0.05 for all), and isolates from patients >65 years were least susceptible to ciprofloxacin (71{\%}). For S. aureus, susceptibility to oxacillin, clindamycin, and levofloxacin was highest among children and decreased with increasing age (p <.001 for all). For S. pneumoniae, pediatric isolates were less susceptible than adult isolates to all agents except penicillin (IV breakpoint). Within children there were significant differences in susceptibility of inpatient and outpatient isolates of E. coli but not of S. aureus or S. pneumoniae. Conclusions: Stratified antibiograms reveal age - associated differences in susceptibility of E. coli, S. aureus, and S. pneumoniae that are obscured by hospital-wide antibiograms. Age-stratified antibiograms have potential to influence antibiotic selection.",
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AB - Background: Antibiograms created by aggregating hospital-wide susceptibility data from diverse patients can be misleading. To demonstrate the utility of age- and location-stratified antibiograms, we compared stratified antibiograms for three common bacterial pathogens, E. coli, S. aureus, and S. pneumoniae. We created stratified antibiograms based on patient age (<18 years, 18-64 years, >/=65 years), and inpatient or outpatient location using all 2009 E. coli and S. aureus, and all 2008-2009 S. pneumoniae isolates submitted to our clinical microbiology laboratory. We compared susceptibility rates among cumulative and stratified antibiograms using descriptive statistics. Findings: For E. coli and S. aureus, the institution-wide antibiogram overestimated resistance in pediatic isolates and underestimated resistance in isolates from the elderly. For E. coli, pediatric isolates were less susceptible to ampicillin and ampicillin-sulbactam and more susceptible to gentamicin and ciprofloxacin compared to adult isolates (p < 0.05 for all), and isolates from patients >65 years were least susceptible to ciprofloxacin (71%). For S. aureus, susceptibility to oxacillin, clindamycin, and levofloxacin was highest among children and decreased with increasing age (p <.001 for all). For S. pneumoniae, pediatric isolates were less susceptible than adult isolates to all agents except penicillin (IV breakpoint). Within children there were significant differences in susceptibility of inpatient and outpatient isolates of E. coli but not of S. aureus or S. pneumoniae. Conclusions: Stratified antibiograms reveal age - associated differences in susceptibility of E. coli, S. aureus, and S. pneumoniae that are obscured by hospital-wide antibiograms. Age-stratified antibiograms have potential to influence antibiotic selection.

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