2017 statewide antibiogram report - mass.gov€¦ · web view2018/07/02 · these data are...
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Bureau of Infectious Disease and Laboratory Sciences
2017 Statewide Antibiogram Report
Bureau of Infectious Disease and Laboratory SciencesMassachusetts State Public Health Laboratory Requests for additional data can be emailed to:305 South Street [email protected] Jamaica Plain, MA 02130 Tel: (617) 983-6550Fax: (617) 983-6925 Acknowledgements:
Quynh Vo, MPH Kerri Barton, MPH
To speak to the on-call epidemiologist: Evan Caten, MS (617) 983-6800 Melissa Cumming, MPH
Jessica Fisler, MPH Jessica Leaf, MPH Scott Troppy, MPHAlfred DeMaria, Jr., MD
In 2017, antibiogram data representing 72 (97%) acute-care hospitals was reported and is included in this statewide report. Each page of this eleven page report displays the average percent susceptibility (red dots) and standard deviation (red bars) of bacterial isolates to relevant antibiotics. These data are representative of antibiotic susceptibility data for 244,918 inpatient and outpatient bacterial isolates, and does not represent the full extent of antibiotic resistance in Massachusetts.
Table of Contents
Acinetobacter baumannii Susceptibility Rates………………………………………………………………………………….1
Pseudomonas aeruginosa Susceptibility Rates…………………………………………………………………………………2
Enterobacter aerogenes Susceptibility Rates……………………………………………………………………………………3
Enterobacter cloacae Susceptibility Rates………………………………………………………………………………………..4
Escherichia coli Susceptibility Rates…………………………………………………………………………………………………5
Klebsiella pneumoniae Susceptibility Rates………………………………………………………………………………………6
Stenotrophomonas maltophilia Susceptibility Rates………………………………………………………………………..7
Serratia marcescens Susceptibility Rates………………………………………………………………………………………….8
Klebsiella oxytoca Susceptibility Rates……………………………………………………………………………………………..9
Staphylococcus aureus Susceptibility Rates……………………………………………………………………………………10
Streptococcus pneumoniae Susceptibility Rates…………………………………………………………………………….11
Antibiogram data collection tool …………………………………………………………………………………………………..12
List of reporting hospitals………………………………………………………………………………………………………………13
Antibiotic susceptibility testing guidelines…..…………………………………………………………………………………14
SusceptibilityHospital=STATEWIDE
Rates - 2017100
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
90
80
70
60
50
40
30
20
10
0
26
30
44
71
767979
81848483
88969589
9493
% S
usce
ptib
le
AM
IKA
CIN
AM
P/SU
L
CEF
EPIM
E
CEF
OTA
XIM
E
CEF
TAZI
DIM
E
CEF
TRIA
XO
NE
CIP
RO
FLO
XA
CIN
ERTA
PEN
EM
GEN
TAM
ICIN
IMIP
ENEM
LEV
OFL
OX
AC
IN
MER
OPE
NEM
PIP/
TAZO
TETR
AC
YC
LIN
E
TIG
ECY
CLI
NE
TMS
TOB
RA
MY
CIN
1
SusceptibilityHospital=STATEWIDE
Rates - 2017
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
100
90
80
70
60
50
40
30
20
10
00
70
74
78
8587
898989929196
% S
usce
ptib
le
AM
IKA
CIN
AZT
REO
NA
M
CEF
EPIM
E
CEF
TAZI
DIM
E
CIP
RO
FLO
XA
CIN
ERTA
PEN
EM
GEN
TAM
ICIN
IMIP
ENEM
LEV
OFL
OX
AC
IN
MER
OPE
NEM
PIP/
TAZO
TOB
RA
MY
CIN
2
SusceptibilityHospital=STATEWIDE
Rates - 2017100
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
90
80
70
60
50
40
30
20
10
00
2
11
73
88
84 84
88969798989898
100
% S
usce
ptib
le
AM
IKA
CIN
AM
OX
/CLA
V
AZT
REO
NA
M
CEF
EPIM
E
CEF
OTA
XIM
E
CEF
OX
ITIN
CEF
TRIA
XO
NE
CEF
UR
OX
IME
CIP
RO
FLO
XA
CIN
ERTA
PEN
EM
GEN
TAM
ICIN
IMIP
ENEM
LEV
OFL
OX
AC
IN
PIP/
TAZO
TMS
3
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
Susceptibility Rates - 2017Hospital=STATEWIDE
100
90
80
70
60
50
40
30
20
10
00
21
68
81
8786
919697969695
94100
% S
usce
ptib
le
AM
IKA
CIN
AM
OX
/CLA
V
AZT
REO
NA
M
CEF
EPIM
E
CEF
OTA
XIM
E
CEF
OX
ITIN
CEF
TRIA
XO
NE
CEF
UR
OX
IME
CIP
RO
FLO
XA
CIN
ERTA
PEN
EM
GEN
TAM
ICIN
IMIP
ENEM
LEV
OFL
OX
AC
IN
PIP/
TAZO
TMS
4
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
Susceptibility Rates - 2017Hospital=STATEWIDE
100
90
80
70
60
50
40
30
20
10
0
53
61
71
757878
8180
909089
999397100100
% S
usce
ptib
le
AM
IKA
CIN
AM
OX
/CLA
V
AM
P/SU
L
AM
PIC
ILLI
N
CEF
EPIM
E
CEF
OTA
XIM
E
CEF
OTE
TAN
CEF
OX
ITIN
CEF
TRIA
XO
NE
CEF
UR
OX
IME
CIP
RO
FLO
XA
CIN
ERTA
PEN
EM
GEN
TAM
ICIN
IMIP
ENEM
LEV
OFL
OX
AC
IN
TMS
5
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
Susceptibility Rates - 2017Hospital=STATEWIDE
100
90
80
70
60
50
40
30
20
10
0
74
84
88879590
929294100999494999499
% S
usce
ptib
le
AM
IKA
CIN
AM
OX
/CLA
V
AM
P/SU
L
CEF
EPIM
E
CEF
OTA
XIM
E
CEF
OTE
TAN
CEF
OX
ITIN
CEF
TRIA
XO
NE
CEF
UR
OX
IME
CEP
HA
LOTH
IN
CIP
RO
FLO
XA
CIN
ERTA
PEN
EM
GEN
TAM
ICIN
IMIP
ENEM
LEV
OFL
OX
AC
IN
TMS
6
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
Hospital=STATEWIDE
Susceptibility Rates - 2017100
90
80
70
60
50
40
30
20
10
00
53
85
94
% S
usce
ptib
le
CEF
TAZI
DIM
E
ERTA
PEN
EM
LEV
OFL
OX
AC
IN
TMS
7
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
Susceptibility Rates - 2017Hospital=STATEWIDE
100
90
80
70
60
50
40
30
20
10
00 11
77
96979699991009499
100
% S
usce
ptib
le
AM
IKA
CIN
AM
OX
/CLA
V
CEF
EPIM
E
CEF
OTA
XIM
E
CEF
OX
ITIN
CEF
TRIA
XO
NE
CEF
UR
OX
IME
CIP
RO
FLO
XA
CIN
ERTA
PEN
EM
GEN
TAM
ICIN
IMIP
ENEM
LEV
OFL
OX
AC
IN
TMS
8
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
Susceptibility Rates - 2017Hospital=STATEWIDE
100
90
80
70
60
50
40
30
20
10
0
57
71
75
899695
949898979892100100100100
% S
usce
ptib
le
AM
IKA
CIN
AM
OX
/CLA
V
AM
P/SU
L
CEF
EPIM
E
CEF
OTA
XIM
E
CEF
OTE
TAN
CEF
OX
ITIN
CEF
TRIA
XO
NE
CEF
UR
OX
IME
CEP
HA
LOTH
IN
CIP
RO
FLO
XA
CIN
ERTA
PEN
EM
GEN
TAM
ICIN
IMIP
ENEM
LEV
OFL
OX
AC
IN
TMS
9
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
Susceptibility Rates - 2017Hospital=STATEWIDE
100
90
80
70
60
50
40
30
20
10
0
44
49
64
7372
9793100100
% S
usce
ptib
le
10
Antibiotic
Overall State Mean (with 1 SD)
NOTE: Data from facilities may or may not include results on duplicate isolates.
Hospital=STATEWIDE
Susceptibility Rates - 2017
100
90
80
70
60
50
40
30
20
10
0
59
7675
8083
868795
97929993
100100
% S
usce
ptib
le
AM
OX
/CLA
V
CLI
ND
AM
YC
IN
CR
O <
=0.5
ug/
ml
CR
O <
=1 u
g/m
l
CTX
<=0
.5 u
g/m
l
CTX
<=1
ug/
ml
ERY
THR
OM
YC
IN
LEV
OFL
OX
AC
IN
LIN
EZO
LID
PEN
<=0
.06
ug/m
l
PEN
<=2
ug/
ml
TETR
AC
YC
LIN
E
TMS
VA
NC
OM
YC
IN
11
S. pneumoniae
MSSA
MRSA
ALL S. aureus
Gram
Positive O
rganisms
N N N N
Variable N (Yes/No)
N *
Amoxicilin +Clavulanate
Ampicillin
Ampicillin+Sulbactam
Azithromycin
Cefazolin
Cefotaxime <=1 ug/ml
Cefotaxime <=0.5 ug/ml
Ceftriaxone<=1 ug/ml
Ceftriaxone<=0.5 ug/ml
Ciprofloxacin
Clindamycin
Daptomycin
Erythromycin
Gentamicin
Levofloxacin
Linezolid
Moxifloxacin
Nitrofurantoin
Oxacillin
Penicillin <=2ug/ml
Penicillin <=0.06 ug/ml
Quinupristin+Dalfopristin
Rifampin
Sulfamethoxazole
Tetracycline
Tigecycline
Trimethoprim+Sulfamethoxazole
Vancomycin
Variable N (expand/collapse)
Variable N (expand/collapse)
Trimethoprim+Sulfamethoxazole
Tobramycin
Tigecycline
Ticarcillin+Clavulanate
Tetracycline
Sulfamethoxazole
Piperacillin +Tazobactam
Nitrofurantoin
Moxifloxacin
Meropenem
Levofloxacin
Imipenem
Gentamicin
Ertapenem
Doripenem
Ciprofloxacin
Cephalothin
Cefuroxime
Ceftriaxone
Ceftazidime
Cefoxitin
Cefotetan
Cefotaxime
Cefepime
Cefazolin
Aztreonam
Ampicillin+Sulbactam
Ampicillin
Amoxicillin +Clavulanate
Amikacin
Variable N (Yes/No)
Massachusett
s Departm
ent of Public Health
Bureau of Infectious D
isease305 South Street, Jam
aica Plain, MA 02130 / Phone: 617-983-6800
Save AsEM
ail Submit
Hospital:From
:To:
Duplicates Excluded?:Patient Population:
Specify (if other):Percent Susceptibilities
Gram N
egative O
rganisms
N *
NA. baum
annii
E. aerogenesN
E. cloacaeN
E. coliNN
K. oxytoca
K. pneumoniae
N
P. aeruginosaN
S. marcescens
N
S. maltophilia
N
12
13
Hospitals that reported 2017 antibiogram data in accordance with regulations (105 CMR 300.000) by reporting deadline:
Anna Jaques Hospital Lowell General Hospital - Main CampusAthol Memorial Hospital Lowell General Hospital - Saints CampusBaystate Franklin Medical Center Martha's Vineyard HospitalBaystate Medical Center Massachusetts Eye and Ear InfirmaryBaystate Noble Hospital Massachusetts General HospitalBaystate Wing Hospital Mercy Medical CenterBerkshire Health Systems - Berkshire Medical Center MetroWest Medical Center - Framingham Union HospitalBerkshire Health Systems - Fairview Hospital MetroWest Medical Center - Leonard Morse HospitalBeth Israel Deaconess Hospital - Milton Milford Regional Medical CenterBeth Israel Deaconess Hospital - Needham Mount Auburn HospitalBeth Israel Deaconess Hospital - Plymouth Nantucket Cape Cod HospitalBeth Israel Deaconess Medical Center New England Baptist HospitalBoston Children's Hospital Newton-Wellesley HospitalBoston Medical Center Saint Vincent HospitalBoston Medical Center - East Newton campus Shriners Hospital for Children - BostonBrigham and Women’s Faulkner Hospital Signature Healthcare - Brockton HospitalBrigham and Women's Hospital South Shore HospitalCambridge Health Alliance - Cambridge Hospital Southcoast Health - Charlton Memorial HospitalCambridge Health Alliance - Somerville Hospital Southcoast Health - St. Luke's HospitalCambridge Health Alliance - Everett Hospital Southcoast Health - Tobey HospitalCape Cod Healthcare - Cape Cod Hospital Steward Health Care - Carney HospitalCape Cod Healthcare - Falmouth Hospital Steward Health Care - Good Samaritan Medical CenterCooley Dickinson Hospital Steward Health Care - Holy Family HospitalDana-Farber Cancer Institute Steward Health Care - Holy Family Hospital at Merrimack ValleyEmerson Hospital Steward Health Care - Morton HospitalHallmark Health System - Lawrence Memorial Hospital of Medford Steward Health Care - Nashoba Valley Medical Center Hallmark Health System - Melrose-Wakefield Hospital Steward Health Care - Norwood HospitalHarrington Memorial Hospital Steward Health Care - Saint Anne's Hospital Heywood Hospital Steward Health Care - St. Elizabeth's Medical CenterHolyoke Medical Center Sturdy Memorial HospitalLahey Health - Addison Gilbert Hospital The Veteran’s Administration Boston Healthcare SystemLahey Health – Beverly Hospital Tufts Medical CenterLahey Health - Lahey Hospital & Medical Center UMass Memorial Health Care – HealthAlliance Hospital Leominster Lahey Health – Lahey Medical Center, Peabody UMass Memorial Health Care – Umass Memorial Medical Center Lahey Health – Winchester Hospital UMass Memorial Health Care – Clinton Hospital
Lawrence General Hospital UMass Memorial Health Care – Marlborough Hospital
14
Antibiotic susceptibility testing guidelines
Antibiotic susceptibility testing is conducted in microbiology laboratories. Microbiologists utilize standardized guidelines, such as those distributed by Clinical and Laboratory Standards Institute (CLSI)* to determine whether a bacterial isolate is susceptible, intermediate, or resistant to an antibiotic. These guidelines are typically updated periodically. The extent to which clinical microbiology laboratories across Massachusetts follow the most recently updated guidelines is not well established.
* Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing, 26th Edition. CLSI Supplement M100-S6. Published December 22, 2015.