UNIVERSITY OF CINCINNATI MEDICAL CENTER UC Health, Cincinnati, Ohio 2018 Antibiogram Preparation Information General The UCMC Antibiograms for 2018 have been compiled using WHONET software from the World Health Organization Only first isolates from patients in UCMC inpatient locations or from the UCEC are included in these antibiograms The primary susceptibility platform employed for testing in 2108 was the Biomerieux Vitek® System The drugs included in this antibiogram report are the drugs routinely tested and reported at UC Health These drugs are selected based on a combination of the following: CLSI recommendations, the UC Health formulary, and availability of these drugs on the commercial susceptibility panels Drugs not tested or not indicated for a given source or organism are left blank Only organisms with 20 or more isolates are included on the antibiogram CLSI recommends using 30 isolates as the cutoff, so those between 20 and 30 are shaded gray If the percentage of susceptible isolates increased by ≥ 10% compared to the previous year’s data, the table cell has been shaded green; a decrease by ≥ 10% compared to the previous year’s data has been shaded red Gram Positive Antibiogram Notes: o Results for Staphylococcus aureus are presented in aggregate and broken down based upon MRSA/MSSA o The isolates included in the report not include MRSA Surveillance Screen cultures or Staphylococcal pneumonia Nasal Swab cultures o Staphylococci may possess a resistance mechanism to lincosamides that is induced by exposure to macrolides All Staphylococcus species are routinely screened for inducible clindamycin resistance When this resistance is found, the interpretive result is modified to Resistant and no MIC value is reported o Results listed for Staphylococcus epidermidis are based on isolates identified to species; this does not represent an aggregation of results for all coagulase-negative staphylococci Gentamicin 47 0 75 0 72 100 100 100 87 95 98 95 95 99 100 88 99 80 98 84 73 92 90 92 76 98 100 99 72 97 98 100 96 77 97 91 76 70 30 81 99 87 93 98 98 94 92 91 94 100 91 91 99 76 97 98 100 97 77 97 93 76 72 30 77 99 94 81 100 98 100 99 100 100 99 100 99 100 87 100 61 79 98 86 77 96 93 94 95 100 100 90 91 100 98 98 93 93 92 92 100 93 95 93 *Cefazolin values reflect the percentage of Non-Resistant isolates using an MIC breakpoint of ≤ µg/mL If the percentage of susceptible isolates increased by ≥ 10% compared to the previous year’s data, the table cell has been shaded green; a decrease by ≥ 10% compared to the previous year’s data has been shaded red Trimethoprim/Sulfamethoxazole Ciprofloxacin 56 57 81 85 15 0 96 0 81 24 91 71 0 Tobramycin Ceftriaxone Meropenem Cefepime 87 Levofloxacin Cefazolin* Percent Susceptible Ampicillin Emergency & Inpatient Ampicillin/Sulbactam Gram Negative Organisms Gram Negative Organism (# of patient isolates) Acinetobacter baumannii (56) Citrobacter freundii (34) Citrobacter koseri (diversus) (46) Enterobacter aerogenes (52) Enterobacter cloacae complex (174) Escherichia coli (1,221) Klebsiella oxytoca (92) Klebsiella pneumoniae (420) Morganella morganii (21) Proteus mirabilis (177) Providencia stuartii (20) Pseudomonas aeruginosa (423) Serratia marcescens (97) Stenotrophomonas maltophilia (85) 01/01/2018 – 12/31/2018 2018 Antibiogram Piperacillin/Tazobactam University of Cincinnati Medical Center 81 93 100 96 90 75 93 90 81 75 85 98 87 75 95 82 83 94 79 95 64 47 91 100 49 100 28 74 56 69 Vancomycin 25 23 95 94 97 82 97 78 Trimethoprim/Sulfamethoxazole 100 95 97 100 100 100 100 100 100 Penicillin G 76 21 73 Oxacillin 35 12 59 26 68 48 Linezolid Levofloxacin 72 67 76 49 65 82 25 27 97 95 99 87 100 Percent Susceptible Erythromycin 100 24 Doxycycline Clindamycin Ceftriaxone Cefotaxime Emergency & Inpatient Ampicillin Gram Positive Organisms Gram Positive Organism (# of patient isolates) Enterococcus faecalis (311) Enterococcus faecium (115) Staphylococcus aureus (822) S aureus- MRSA (437) S aureus- MSSA (415) Staphylococcus epidermidis (157) Staphylococcus lugdunensis (31) Streptococcus pneumoniae (86) non-meningitis therapy interpretations meningitis therapy interpretations Streptococcus viridans group (71) 01/01/2018 – 12/31/2018 2018 Antibiogram Tetracycline University of Cincinnati Medical Center 95 92 97 49 100 84 97 39 100 100 100 100 100 100 59 100 *Streptococcus pneumoniae MIC interpretations for Cefotaxime, Ceftriaxone, and Penicillin-G vary based on achievable drug levels in the CSF versus blood Percentages were calculated by applying both sets of interpretations to all 86 isolates If the percentage of susceptible isolates increased by ≥ 10% compared to the previous year’s data, the table cell has been shaded green; a decrease by ≥ 10% compared to the previous year’s data has been shaded red