Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Sepsis Outcome Programme (AESOP) Annual Report 2020
DOI:
https://doi.org/10.33321/cdi.2022.46.17Keywords:
Australian Group on Antimicrobial Resistance (AGAR), antimicrobial resistance surveillance, Enterococcus faecium, Enterococcus faecalis, vancomycin-resistant enterococci (VRE), bacteraemiaAbstract
From 1 January to 31 December 2020, forty-nine institutions around Australia participated in the Australian Enterococcal Sepsis Outcome Programme (AESOP). The aims of AESOP 2020 were to determine the proportion of enterococcal bacteraemia isolates in Australia that were antimicrobial-resistant, and to characterise the molecular epidemiology of the E. faecium isolates. Of the 1,230 unique episodes of enterococcal bacteraemia investigated, 93.9% were caused by either E. faecalis (54.2%) or E. faecium (39.7%). Ampicillin resistance was not detected in E. faecalis but was detected in 88.2% of E. faecium . Vancomycin non-susceptibility was detected in 0.2% of E. faecalis and 32.6% of E. faecium . Overall, 35.2% of E. faecium harboured vanA and/or vanB genes. For the vanA/B positive E. faecium isolates, 38.8% harboured the vanA gene, 60.6% the vanB gene, and 0.6% harboured both vanA and vanB . Although the percentage of E. faecium bacteraemia isolates was significantly lower than that detected in the 2019 AESOP (presumably due to the COVID-19 elective surgery restrictions placed on hospitals), it remains substantially higher than that recorded in most European countries. The E. faecium isolates detected consisted of 71 multilocus sequence types (STs), with 81.7% of these isolates classified into eight major STs each containing ten or more isolates. All major STs belonged to clonal cluster 17 (CC17), a major hospital-adapted polyclonal E. faecium cluster. The major STs (ST17, ST1424, ST80, ST796, ST78, ST1421, ST555 and ST117) were found across most regions of Australia. The predominant clone was ST17, which was identified in all regions except the Northern Territory. Overall, 40.9% of isolates belonging to the eight major STs harboured the vanA or vanB gene. The AESOP 2020 has shown enterococcal bacteraemia episodes in Australia are frequently caused by polyclonal ampicillin-resistant high-level gentamicin-resistant vanA - or vanB -positive E. faecium which have limited treatment options.
Downloads
References
Pinholt M, Ostergaard C, Arpi M, Bruun NE, Schønheyder HC, Gradel KO et al. Incidence, clinical characteristics and 30-day mortality of enterococcal bacteraemia in Denmark 2006–2009: a population-based cohort study. Clin Microbiol Infect . 2014;20(2):145–51.
Deshpande LM, Fritsche TR, Moet GJ, Biedenbach DJ, Jones RN. Antimicrobial resistance and molecular epidemiology of vancomycin-resistant enterococci from North America and Europe: a report from the SENTRY antimicrobial surveillance program. Diagn Microbiol Infect Dis . 2007;58(2):163–70.
Murray BE. The life and times of the Enterococcus. Clin Microbiol Rev . 1990;3(1):46–65.
Simonsen CS, Småbrekke L, Monnet DL, Sørensen TL, Møller JK, Kristinsson KG et al. Prevalence of resistance to ampicillin, gentamicin and vancomycin in Enterococcus faecalis and Enterococcus faecium isolates from clinical specimens and use of antimicrobials in five Nordic hospitals. J Antimicrob Chemother . 2003;51(2):323–31.
Treitman AN, Yarnold PR, Warren J, Noskin GA. Emerging incidence of Enterococcus faecium among hospital isolates (1993 to 2002). J Clin Microbiol . 2005;43(1):462–3.
Boucher HW, Talbot GH, Bradley JS, Edwards JE, Gilbert D, Rice LB et al. Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. Clin Infect Dis . 2009;48(1):1–12.
Christiansen KJ, Turnidge JD, Bell JM, George NM, Pearson JC, Australian Group on Antimicrobian Resistance. Prevalence of antimicrobial resistance in Enterococcus isolates in Australia, 2005: report from the Australian Group on Antimicrobial Resistance. Commun Dis Intell Q Rep . 2007;31(4):392–7.
Coombs GW, Daley D, Pearson JC, Ingram PR. A change in the molecular epidemiology of vancomycin resistant enterococci in Western Australia. Pathology . 2014;46(1):73–5.
Coombs GW, Pearson JC, Daley DA, Le T, Robinson OJ, Gottlieb T et al. Molecular epidemiology of enterococcal bacteremia in Australia. J Clin Microbiol . 2014;52(3):897–905.
Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing . 31st ed. CLSI supplement M100. Wayne, PA: CLSI; 2021.
The European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters. Version 11.0 . Basel: EUCAST; 2021. Available from: https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_11.0_Breakpoint_Tables.pdf.
Seemann T, Goncalves da Silva A, Bulach DM, Schultz MB, Kwong JC, Howden BP. Nullarbor . San Francisco; Github. [Accessed on 3 Jun 2016.] Available from: https://github.com/tseemann/nullarbor.
European Centre for Disease Prevention and Control (ECDC). Surveillance Atlas of Infectious Diseases. [Webpage.] Solna: ECDC. Available from: http://atlas.ecdc.europa.eu/public/index.aspx.
Coombs GW, Pearson JC, Daly DA, Le TT, Robinson JO, Gottlieb T et al. Australian Enterococcal Sepsis Outcome Programme annual report, 2013. Commun Dis Intell Q Rep . 2014;38(4):E320–6.
Coombs GW, Daley DA, Lee YT, Pang S, Pearson JC, Robinson JO et al. Australian Group on Antimicrobial Resistance Australian Enterococcal Sepsis Outcome Programme annual report, 2014. Commun Dis Intell Q Rep . 2016;40(2):E236–43.
Coombs GW, Daley DA, Lee YT, Pang S, Bell JM, Turnidge JD et al. Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Sepsis Outcome Programme (AESOP) Annual Report 2015. Commun Dis Intell (2018) . 2018;42. pii: S2209-6051(18)00015-5.
Coombs GW, Daley DA, Lee YT, Pang S, Australian Group on Antimicrobial Resistance. Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Sepsis Outcome Programme (AESOP) Annual Report 2016. Commun Dis Intell (2018) . 2018;42. pii: S2209-6051(18)00020-9.
Geoffrey W Coombs, Denise A Daley, Yung Thin Lee, Dr Stanley Pang. Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Sepsis Outcome Programme (AESOP) Annual Report 2017. Commun Dis Intell (2018) . 2019;43. doi: https://doi.org/10.33321/cdi.2019.43.42.
Coombs GW, Daley DA, Mowlaboccus S, Lee YT, Pang S, Australian Group on Antimicrobial Resistance. Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Sepsis Outcome Programme (AESOP) Annual Report 2018. Commun Dis Intell (2018) . 2020;44. doi: https://doi.org/10.33321/cdi.2020.44.19.
Coombs GW, Daley DA, Mowlaboccus S, Pang S, Australian Group on Antimicrobial Resistance. Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Sepsis Outcome Programme (AESOP) Annual Report 2019. Commun Dis Intell (2018) . 2020;44. doi: https://doi.org/10.33321/cdi.2020.44.72.
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2022 Communicable Diseases Intelligence
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
