Overall there were no significant changes in the antibiogram from 2021 to 2022.
Gram Negative bacteria:
- Escherichia coli remains the most common gram negative bacteria isolated across all specimens (makes up 65%). Of all E.coli isolated, 12% are ESBL (extended-spectrum beta-lactamase)
- Pseudomonas aeruginosa rates remain stable and makes up 8% of all gram negative bacteria isolates across all specimens. Therefore, please keep in mind when selecting empiric antibiotics to provide Pseudomonas aeruginosa coverage only if patient has risk factors.
- There is a general trend towards decreasing Ciprofloxacin sensitivities in gram negative isolates (mainly for E. Coli)
Gram Positive bacteria:
- MRSA (methicillin-resistant Staphylococcus aureus) rates remain stable and makes up 10% of all Staphyloccocus aureus blood isolates and 14% of all Staphylococcus aureus isolates across all specimens
Summary of Recommendations:
Urinary Tract Infections (UTI)
Recommendation:
- Nitrofurantoin remains as first-line empiric option for uncomplicated UTI/cystitis
- Ciprofloxacin should NOT be used due to poor sensitivities shown in antibiogram
Alternative Options: Trimethoprim-Sulfamethoxazole and Cephalexin (to replace previously recommended amoxicillin-clavulanate as empiric alternative for uncomplicated UTI/cystitis).
Skin and Soft Tissue Infections (SSTI) – Mild to Moderate
Recommendation:
- Cefazolin/Cephalexin remains as first-line empiric options
- Clindamycin should NOT be used due to poor sensitivities shown in antibiogram
Alternative Options: Trimethoprim-Sulfamethoxazole is a good alternative if the patient has a true beta-lactam allergy or when there are risk factors for MRSA
Intra-abdominal Infections
Recommendation:
- Cefazolin (if uncomplicated) or Ceftriaxone (if risk factors for complications) + Metronidazole
- Ciprofloxacin should NOT be used due to poor sensitivities shown in antibiogram
Alternative Options: Trimethoprim-Sulfamethoxazole (to replace previously recommended ciprofloxacin as empiric alternative) + Metronidazole