Why don't you search it on MedLine or PubMed or even on WHO sites.

Dear Valery,

Check these out:

The Management of Invasive Group A Streptococcal Infections in Ireland. Invasive Group A Streptococcus Sub-Committee Health Protection Surveillance Centre

http://www.infectioncontrolmanual.co.ni/index.php?option=com_content&view=category&id=14&Itemid=118

Relevant and related studies from PubMed:

1. J Hosp Infect. 2015 Feb 21. pii: S0195-6701(15)00070-5. doi:

10.1016/j.jhin.2015.01.018. [Epub ahead of print]

Detection and characterization of extended-spectrum beta-lactamase-producing

Enterobacteriaceae in high-risk patients in an Irish tertiary care hospital.

O'Connell N(1), Keating D(2), Kavanagh J(2), Schaffer K(2).

Author information:

(1)Department of Microbiology, St. Vincent's University Hospital and School of

Medicine and Medical Science, University College Dublin, Dublin, Ireland.

Electronic address: n.o'[email protected]. (2)Department of Microbiology, St.

Vincent's University Hospital and School of Medicine and Medical Science,

University College Dublin, Dublin, Ireland.

BACKGROUND: Extended-spectrum beta-lactamase-producing Enterobacteriaceae

(ESBL-E) are Gram-negative, multi-drug-resistant organisms that are of major

clinical significance among immunocompromised patients in high-risk areas in

hospital settings. In Ireland, the number of ESBL-E bloodstream infections is

increasing.

AIMS: To conduct a prevalence study of ESBL-E among immunocompromised patients in

high-risk areas [intensive care unit (ICU), liver transplantation and

haematology/oncology wards], characterize any ESBL genes detected by polymerase

chain reaction (PCR), and perform epidemiological typing using pulsed-field gel

electrophoresis (PFGE).

METHODS: In total, 317 non-duplicate rectal swabs from patients in high-risk

wards were screened anonymously for ESBL-E carriage. Positive isolates were

characterized using PCR to detect blaCTX-M, blaTEM, blaOXA-1 and blaSHV ESBL-E

genes. Clonal relationships of these isolates were investigated using PFGE.

FINDINGS: Fifty (15.8%) high-risk patients were found to harbour ESBL-E.

Prevalence rates of 21.9% (N = 28), 14.3% (N = 15) and 8.3% (N = 7) of ESBL-E

were isolated from patients on the liver transplantation, ICU and

haematology/oncology wards, respectively. Seventy percent of ESBL-E isolates

carried more than one resistance gene. Of the 25 ESBL-producing Escherichia coli

isolates typed by PFGE, two pairs of two isolates demonstrated >80% homology, and

four of the five ESBL-producing Enterobacter cloacae isolates typed by PFGE

demonstrated >80% homology, suggesting clonal relatedness and potential

cross-transmission from individual patients.

CONCLUSION: A significant proportion of the patients screened were found to be

colonized with ESBL-E. Typing revealed three incidents of potential

cross-infection. Therefore, timely detection of ESBL-E among patients in

high-risk wards is critical for treatment and infection control.

Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All

rights reserved.

PMID: 25799484 [PubMed - as supplied by publisher]

2. Int J Food Microbiol. 2014 Jun 2;179:24-32. doi:

10.1016/j.ijfoodmicro.2014.03.019. Epub 2014 Mar 27.

Array based detection of antibiotic resistance genes in Gram negative bacteria

isolated from retail poultry meat in the UK and Ireland.

McNeece G(1), Naughton V(1), Woodward MJ(2), Dooley JS(1), Naughton PJ(3).

Author information:

(1)Northern Ireland Centre for Food and Health, School of Biomedical Sciences,

University of Ulster, Cromore Road, Coleraine, Co. Londonderry BT52 1SA, United

Kingdom. (2)Department of Food and Nutritional Sciences, The University of

Reading, PO Box 226, Whiteknights, Reading RG6 6AP, United Kingdom. (3)Northern

Ireland Centre for Food and Health, School of Biomedical Sciences, University of

Ulster, Cromore Road, Coleraine, Co. Londonderry BT52 1SA, United Kingdom.

Electronic address: [email protected].

The use of antibiotics in birds and animals intended for human consumption within

the European Union (EU) and elsewhere has been subject to regulation prohibiting

the use of antimicrobials as growth promoters and the use of last resort

antibiotics in an attempt to reduce the spread of multi-resistant Gram negative

bacteria. Given the inexorable spread of antibiotic resistance there is an

increasing need for improved monitoring of our food. Using selective media, Gram

negative bacteria were isolated from retail chicken of UK-Intensively reared

(n=27), Irish-Intensively reared (n=19) and UK-Free range (n=30) origin and

subjected to an oligonucleotide based array system for the detection of 47

clinically relevant antibiotic resistance genes (ARGs) and two integrase genes.

High incidences of β-lactamase genes were noted in all sample types, acc (67%),

cmy (80%), fox (55%) and tem (40%) while chloramphenicol resistant determinants

were detected in bacteria from the UK poultry portions and were absent in

bacteria from the Irish samples. Denaturing Gradient Gel Electrophoresis (DGGE)

was used to qualitatively analyse the Gram negative population in the samples and

showed the expected diversity based on band stabbing and DNA sequencing. The

array system proved to be a quick method for the detection of antibiotic

resistance gene (ARG) burden within a mixed Gram negative bacterial population.

Copyright © 2014 Elsevier B.V. All rights reserved.

PMID: 24713169 [PubMed - indexed for MEDLINE]

3. J Antimicrob Chemother. 2014 Oct;69(10):2713-22. doi: 10.1093/jac/dku184. Epub

2014 Jun 10.

Antimicrobial activity of ceftolozane/tazobactam tested against Pseudomonas

aeruginosa and Enterobacteriaceae with various resistance patterns isolated in

European hospitals (2011-12).

Sader HS(1), Farrell DJ(2), Castanheira M(2), Flamm RK(2), Jones RN(2).

Author information:

(1)JMI Laboratories, North Liberty, IA 52317, USA [email protected]. (2)JMI

Laboratories, North Liberty, IA 52317, USA.

OBJECTIVES: To evaluate the in vitro activity of ceftolozane/tazobactam and

comparator agents tested against contemporary Gram-negative bacteria.

Ceftolozane/tazobactam is an antipseudomonal cephalosporin combined with a

well-established β-lactamase inhibitor.

METHODS: A total of 10 532 Gram-negative organisms (2191 Pseudomonas aeruginosa

and 8341 Enterobacteriaceae) were consecutively collected from 31 medical centres

located in 13 European countries plus Turkey and Israel. The organisms were

tested for susceptibility by broth microdilution methods as described by the CLSI

M07-A9 document and the results interpreted according to EUCAST as well as CLSI

breakpoint criteria. Selected ceftazidime- and/or meropenem-resistant P.

aeruginosa isolates were screened for the presence of β-lactamase genes by PCR.

RESULTS: P. aeruginosa exhibited high rates of multidrug-resistant (31.9%) and

extensively drug-resistant (24.6%) isolates and 11.6% of isolates were

susceptible only to colistin. When tested against P. aeruginosa,

ceftolozane/tazobactam (MIC(50), 1 mg/L) was generally 4-fold more active than

ceftazidime (MIC(50), 4 mg/L) and inhibited >90% of isolates with an MIC of ≤8

mg/L in nine countries. In contrast, the highest susceptibility rates observed

for ceftazidime and meropenem, respectively, were 86.0%/86.0% (UK) and

85.2%/86.1% (Ireland) (67.2%/67.1% overall). Ceftolozane/tazobactam (MIC(50/90),

0.25/2 mg/L; 93.7% and 95.2% inhibited at ≤4 and ≤8 mg/L, respectively),

meropenem [MIC(50/90), ≤0.06/≤0.06 mg/L; 98.0% susceptible (EUCAST)] and

tigecycline [MIC(50/90), 0.12/1 mg/L; 94.1% susceptible (EUCAST)] were the most

active compounds tested against Enterobacteriaceae.

CONCLUSIONS: Ceftolozane/tazobactam was the most active β-lactam agent tested

against P. aeruginosa and demonstrated higher in vitro activity than currently

available cephalosporins and piperacillin/tazobactam when tested against

Enterobacteriaceae.

© The Author 2014. Published by Oxford University Press on behalf of the British

Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions,

please e-mail: [email protected].

PMID: 24917579 [PubMed - in process]

4. Euro Surveill. 2013 Jan 24;18(4):20385.

Use of multilocus variable-number tandem repeat analysis (MLVA) in eight European

countries, 2012.

Lindstedt BA(1), Torpdahl M, Vergnaud G, Le Hello S, Weill FX, Tietze E, Malorny

B, Prendergast DM, Ní Ghallchoir E, Lista RF, Schouls LM, Söderlund R, Börjesson

S, Åkerström S.

Author information:

(1)Division of Infectious Diseases Control, Norwegian Institute of Public Health,

Oslo, Norway. [email protected]

Genotyping of important medical or veterinary prokaryotes has become a very

important tool during the last decades. Rapid development of fragment-separation

and sequencing technologies has made many new genotyping strategies possible.

Among these new methods is multilocus variable-number tandem repeat analysis

(MLVA). Here we present an update on the use of MLVA in eight European countries

(Denmark, France, Germany, Ireland, Italy, the Netherlands, Norway and Sweden).

Researchers in Europe have been active in developing and implementing a large

array of different assays. MLVA has been used as a typing tool in several

contexts, from aiding in resolving outbreaks of foodborne bacteria to typing

organisms that may pose a bioterrorist threat, as well as in scientific studies.

PMID: 23369388 [PubMed - indexed for MEDLINE]

5. J Chemother. 2011 Apr;23(2):71-6.

Eight-year (2002-2009) summary of the linezolid (Zyvox® Annual Appraisal of

Potency and Spectrum; ZAAPS) program in European countries.

Ross JE(1), Farrell DJ, Mendes RE, Sader HS, Jones RN.

Author information:

(1)JMI Laboratories, 345 Beaver Kreek Centre, Suite A, North Liberty, Iowa 52317,

USA. [email protected]

The linezolid surveillance network (ZAAPS program) has been monitoring linezolid

activity and susceptibility rates for eight years (2002-2009) in european medical

centers. Samples from 12-24 sites annually in 11 countries were monitored by a

central laboratory design using reference MIC methods with international and

regional interpretations (EUCAST). A total of 13,404 gram-positive pathogens were

tested from 6 pathogen groups. Linezolid remained without documented resistance

from 2002 through 2005, but beginning in 2006 resistant strains emerged at very

low rates among Staphylococcus aureus (G2576T mutant in ireland, 2007),

coagulase-negative staphylococci (CoNS; usually Staphylococcus epidermidis,

France and Italy in 2006-2009) and enterococci (Enterococcus faecium in Germany

[2006, 2008, 2009] and E. faecalis in Sweden [2008], United Kingdom [2008] and

Germany [2009]); all but one strain having a target mutation. A mobile cfr was

detected in an italian CoNS strain (2008 and 2009), and clonal spread was noted

for linezolid-resistant strains (PFGE results). Overall the linezolid

susceptibility rates were >99.9, 99.7 and 99.6% for S. aureus, CoNS and

enterococci, respectively; and all streptococcal strains were susceptible

(MIC(90), 1 mg/l). In conclusion, the ZAAPS program surveillance confirmed high,

sustained levels of linezolid activity from 2002-2009 and without evidence of MIC

creep or escalating resistance in gram-positive pathogens across monitored

european nations.

© E.S.I.F.T. srl - Firenze

PMID: 21571621 [PubMed - indexed for MEDLINE]

6. J Chemother. 2009 Nov;21(5):500-6.

Update on the in vitro activity of daptomycin tested against 17,193 Gram-positive

bacteria isolated from European medical centers (2005-2007).

Sader HS(1), Moet G, Jones RN.

Author information:

(1)JMI Laboratories, North Liberty, Iowa 52317, USA. [email protected]

The antimicrobial susceptibility patterns of 17,193 Gram-positive isolates

consecutively collected from 28 medical centers in 12 countries in europe and

israel in 2005-2007 were evaluated by Clinical and laboratory Standards institute

(CLSI) broth microdilution methods supplemented with calcium to 50 mg/l for

testing daptomycin. Overall, the rate of methicillin-resistant Staphylococcus

aureus (MRSA) was 28.3%, varying from 32.3% in 2005 to 27.1% in 2006 and 28.5% in

2007. Vancomycin resistance rates were 0.8% and 21.5% among Enterococcus faecalis

and E. faecium, respectively. Among E. faecium, vancomycin resistance increased

from 17.9% in 2005 to 26.3% in 2007, and varied from 0.0% in Spain, Sweden and

Switzerland to as high as 54.6% in ireland for 2007. All isolates tested, except

for seven CoNS (0.2%; 3,234 tested) were considered susceptible to daptomycin

using breakpoints established by the United States food and Drug Administration,

the CLSI and the EUCAST. Daptomycin was very active against all Gram-positive

species with the highest minimum inhibitory concentration (MIC) results being 1,

4, 2 and 4 mg/l for S. aureus, coagulase-negative staphylococci, E. faecalis and

E. faecium, respectively. Daptomycin activity was not adversely influenced by

resistance to oxacillin among staphylococci or to vancomycin among enterococci.

PMID: 19933040 [PubMed - indexed for MEDLINE]

7. Cornea. 2009 Apr;28(3):285-92. doi: 10.1097/ICO.0b013e3181877a52.

Risk factors, microbiological findings, and clinical outcomes in cases of

microbial keratitis admitted to a tertiary referral center in ireland.

Saeed A(1), D'Arcy F, Stack J, Collum LM, Power W, Beatty S.

Author information:

(1)Waterford Regional Hospital, Waterford, Ireland. [email protected]

AIM: To identify the risk factors for, and to report the microbiological findings

and clinical outcomes of, severe microbial keratitis (MK).

METHODS: This was a retrospective study of all cases of presumed MK admitted to a

tertiary referral center over a 2-year period (September 2001 to August 2003).

Data recorded included demographic data, details relating to possible risk

factors, results of microbiological studies, clinical findings at presentation,

and clinical and visual outcomes.

RESULTS: Ninety patients were admitted with a diagnosis of presumed MK during the

study period. The mean age of patients was 45 +/- 32 years, and the male to

female ratio was 47:43 (52.2%:47.7%). Predisposing risk factors for MK included

contact lens wear (37; 41.1%), anterior segment disease (19; 21.1%), ocular

trauma (13; 14.4%), systemic disease (5; 5.6%), and previous ocular surgery (1;

1.1%). Cultured organisms included gram-negative bacteria (17; 51.5%),

gram-positive bacteria (11, 33.3%), acanthamoeba (2; 6.1%), and fungi (1; 3%).

Visual acuity improved significantly after treatment [mean best-corrected visual

acuity (+/-standard deviation) at presentation: 0.76 (+/-0.11); mean

best-corrected visual acuity at last follow-up: 0.24 (+/-0.07); P < 0.001].

Secondary surgical procedures were required in 18 (20%) cases, and these included

punctal cautery (1; 1.1%), tissue glue repair of corneal perforation (2; 2.2%),

tarsorrhaphy (9; 9.9%), Botulinum toxin-induced ptosis (1; 1.1%), penetrating

keratoplasty (3; 3.3%), and evisceration (2; 2.2%).

CONCLUSIONS: Contact lens wear remains a significant risk factor for severe MK.

MK remains a threat to vision and to the eye, but the majority of cases respond

to prompt and appropriate antimicrobial therapy.

PMID: 19387229 [PubMed - indexed for MEDLINE]

8. J Antimicrob Chemother. 2008 Nov;62 Suppl 2:ii55-63. doi: 10.1093/jac/dkn352.

Non-susceptibility trends among Pseudomonas aeruginosa and other non-fermentative

Gram-negative bacteria from bacteraemias in the UK and Ireland, 2001-06.

Livermore DM(1), Hope R, Brick G, Lillie M, Reynolds R; BSAC Working Parties on

Resistance Surveillance.

Author information:

(1)Health Protection Agency Centre for Infections, 61 C olindale Avenue, London

NW9 5EQ, UK. [email protected]

BACKGROUND: Pseudomonas and Acinetobacter spp. are important opportunists,

notorious for resistance. Pseudomonas spp. are collected in the British Society

for Antimicrobial Chemotherapy (BSAC) bacteraemia surveillance, with

Acinetobacter spp. and Stenotrophomonas maltophilia well represented in the

'other Gram-negatives' group.

METHODS: Data for collected isolates were reviewed together with LabBase

bacteraemia reports to the Health Protection Agency (HPA). Isolates with unusual

resistances were subjected to molecular investigation.

RESULTS: From 2001 to 2006, the BSAC surveillance collected 1226 Pseudomonas

aeruginosa, 240 Acinetobacter spp.-125 of them Acinetobacter

calcoaceticus/baumannii (Acb) complex-and 165 S. maltophilia. Among P.

aeruginosa, non-susceptibility rates to beta-lactams and gentamicin fluctuated,

without trend, below 10%; those to ciprofloxacin ranged from 16% to 22%. One P.

aeruginosa isolate from 2001 had VIM-2 metallo-beta-lactamase. For Acb, the BSAC

data indicated frequent non-susceptibility, except to imipenem, where only five

non-susceptible isolates were collected, all after 2003, four of them belonging

to the OXA-23 clone 1 lineage which is prevalent in Southeast England. Reports to

the HPA indicated rising imipenem non-susceptibility in Acb (P < 0.0001).

Co-trimoxazole retained near-universal activity against S. maltophilia. Among new

antibiotics, doripenem MICs were /=16 mg/L for Acb OXA-23 clone 1. Ceftobiprole had higher MICs

than ceftazidime for P. aeruginosa, but 81% of the isolates were inhibited at

1 mg/L)

daptomycin MIC value (4 mg/L). Among E. faecalis (MIC50/90, 0.5/1 mg/L; 100%

susceptible) the highest daptomycin MIC value was 2 mg/L; while among E. faecium

(MIC50/90, 2/4 mg/L; 100% susceptible) the highest MIC result was 4 mg/L.

CONCLUSION: Daptomycin showed excellent in vitro activity against staphylococci

and enterococci collected in European medical centers in 2005 and resistance to

oxacillin, vancomycin or quinupristin/dalfopristin did not compromise its

activity overall against these pathogens. Based on these results and those of

previous publications, daptomycin appears to be an excellent therapeutic option

for serious infections caused by oxacillin-resistant staphylococci and

vancomycin-resistant enterococci in Europe.

PMCID: PMC1865382

PMID: 17442104 [PubMed - indexed for MEDLINE]

11. Clin Microbiol Infect. 2006 Sep;12(9):844-52.

Antimicrobial susceptibility of gram-positive bacteria isolated from European

medical centres: results of the Daptomycin Surveillance Programme (2002-2004).

Sader HS(1), Streit JM, Fritsche TR, Jones RN.

Author information:

(1)JMI Laboratories, North Liberty, IA 52317, USA. [email protected]

The antimicrobial susceptibility patterns of 9322 contemporary (2002-2004)

gram-positive bacterial isolates collected from 31 medical centres in 14

countries in Europe were evaluated by broth microdilution methods according to

CLSI guidelines. The isolates collected comprised Staphylococcus aureus (4842

isolates), coagulase-negative staphylococci (CoNS; 1942 isolates), Enterococcus

faecalis (1147 isolates), Enterococcus faecium (391 isolates), beta-haemolytic

streptococci (660 isolates) and viridans group streptococci (340 isolates). The

organisms were tested against daptomycin and more than 20 comparator agents in

Mueller-Hinton broth, supplemented with calcium to 50 mg/L when testing

daptomycin. Overall, methicillin (oxacillin) resistance rates were 26.7% and

77.0% for S. aureus (MRSA) and CoNS, respectively, and the vancomycin resistance

rate among enterococci was 6.1%. MRSA rates varied from 0.6% in Sweden to

40.2-43.0% in Belgium, Greece, Ireland, the UK and Israel, and VRE rates varied

from 0% in Switzerland to 21.2% in Ireland. More than 99.9% of isolates tested

were considered susceptible to daptomycin according to breakpoints established by

the United States Food and Drug Administration and the CLSI. Daptomycin was

active against all gram-positive species, with the highest MIC being 2, 8, 0.5

and 2 mg/L for staphylococci, enterococci, beta-haemolytic streptococci and

viridans group streptococci, respectively. Daptomycin activity was not influenced

adversely by resistance to other agents among staphylococci or enterococci. This

novel lipopeptide (daptomycin) appears to be an excellent alternative therapeutic

option for serious infections caused by multidrug-resistant gram-positive

organisms isolated in Europe.

PMID: 16882289 [PubMed - indexed for MEDLINE]

12. Br J Biomed Sci. 2005;62(1):30-2.

Comparison of in vitro susceptibilities to levofloxacin and ciprofloxacin with

Pseudomonas aeruginosa and Stenotrophomonas maltophilia isolated from cystic

fibrosis patients in Northern Ireland.

McKnight AJ(1), Shaw A, Goldsmith CE, Clarke L, Millar BC, McCaughan J, Elborn

JS, Reid A, Moore JE.

Author information:

(1)Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast

City Hospital, Northern Ireland.

PMID: 15816210 [PubMed - indexed for MEDLINE]

13. J Antimicrob Chemother. 2004 Jun;53(6):1018-32. Epub 2004 May 5.

Antimicrobial susceptibility of the pathogens of bacteraemia in the UK and

Ireland 2001-2002: the BSAC Bacteraemia Resistance Surveillance Programme.

Reynolds R(1), Potz N, Colman M, Williams A, Livermore D, MacGowan A; BSAC

Extended Working Party on Bacteraemia Resistance Surveillance.

Author information:

(1)Department of Medical Microbiology, Southmead Hospital, Bristol BS10 5NB, UK.

[email protected]

OBJECTIVES: To describe the current patterns of antimicrobial resistance in the

major pathogens of bacteraemia in the UK and Ireland, to highlight any unexpected

resistance patterns and to act as a reference baseline for future studies.

METHODS: In 2001 and 2002, 5092 blood culture isolates were collected by 29

laboratories distributed across the UK and Ireland. A single central laboratory

re-identified the isolates and measured MICs by the BSAC agar dilution method.

RESULTS: Oxacillin resistance was found in 42% of Staphylococcus aureus and 76%

of coagulase-negative staphylococci. Streptococci were generally susceptible to

beta-lactams, but tetracycline resistance was common (except in Streptococcus

pneumoniae) and particularly common among group B isolates (82% resistant). Nine

percent of S. pneumoniae had reduced susceptibility to penicillin (MICs 0.12-1

mg/L), but none required >/=2 mg/L for inhibition. High-level gentamicin

resistance was seen in 43% of Enterococcus faecalis, often in combination with

raised ciprofloxacin MICs (>/=32 mg/L), but these isolates remained susceptible

to ampicillin and imipenem. Only linezolid and tigecycline showed in vitro

potency against a large proportion of Enterococcus faecium. Vancomycin resistance

was restricted to enterococci (20% of E. faecium, 3% of E. faecalis) and a single

isolate of coagulase-negative staphylococci (0.2%, MIC of 8 mg/L). Escherichia

coli isolates were commonly resistant to amoxicillin (56%) and tetracycline (88%)

but remained susceptible to ceftazidime, piperacillin/tazobactam and imipenem.

Extended-spectrum beta-lactamases were detected in 2% of E. coli (none in 2001,

3.2% in 2002), 5% of Klebsiella spp. and 8% of Enterobacter spp. Resistance rates

of Pseudomonas aeruginosa to ciprofloxacin, ceftazidime, gentamicin, imipenem and

piperacillin/tazobactam were between 4% and 7%. Among the newly licensed and

developmental agents, there was no resistance to linezolid in Gram-positive

organisms. Ertapenem had a wide spectrum, covering Enterobacteriaceae,

streptococci and oxacillin-susceptible staphylococci. MICs of tigecycline were

low for Gram-positive species and Enterobacteriaceae except Proteeae and

Enterobacter spp.

CONCLUSION: Antimicrobial resistance among major bloodstream pathogens to those

antimicrobials often selected for empirical therapy was relatively uncommon in

2001-2002, usually or =2 mg/L), 89% were

susceptible to erythromycin, 93% susceptible to tetracycline, and 94-100%

intermediate or susceptible to fluoroquinolones. Susceptibility to agents other

than fluoroquinolones was less frequent in the 174 isolates from Ireland:

beta-lactam susceptibility was 68-99% (3.4% having penicillin MICs > or =2 mg/L),

erythromycin susceptibility was 78% and tetracycline susceptibility was 82%. In

multivariate analysis, susceptibility in S. pneumoniae was associated with

country and patient age, being most common overall in the 20-49 years age group.

Of 1894 H. influenzae, 15% produced beta-lactamase and 79-100% were susceptible

to beta-lactams other than cefaclor. Ninety-six per cent were intermediate and 1%

susceptible to erythromycin, 97% susceptible to tetracycline, and 89% susceptible

to trimethoprim. Only one isolate showed resistance to ciprofloxacin. H.

influenzae from sputum were more likely to be susceptible than isolates from

other sources. Of 845 M. catarrhalis, 92% produced beta-lactamase and 9% were

susceptible to ampicillin, >99% were susceptible to co-amoxiclav, cefotaxime,

erythromycin and fluoroquinolones.

CONCLUSIONS: Clinically relevant demographic factors predictive of susceptibility

were country and patient age in S. pneumoniae, and specimen type

(sputum/non-sputum) in H. influenzae. Susceptibility to most antimicrobials

remains high in Ireland and very high in Great Britain.

PMID: 14585865 [PubMed - indexed for MEDLINE]

15. J Hosp Infect. 2001 Sep;49(1):69-73.

Surveillance of hospital-acquired infection in the Republic of Ireland: past,

present and future.

Humphreys H(1), O'Flanagan D.

Author information:

(1)Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland.

[email protected]

There is increasing interest in the surveillance of hospital-acquired infection

(HAI) in the Republic of Ireland due to a greater awareness of the consequences

of antibiotic resistance, and consumer pressure in the form of public

expectations of the quality of health care. To date there have been no nationwide

prospective surveillance projects but surveillance has taken place in the form of

participation in international and national studies, and the description of local

outbreaks. Infection control teams and others have participated in projects such

as a European study of HAI in intensive care units conducted in 1992, the second

national prevalence study conducted in the UK in 1993 and two surveys of

methicillin-resistant Staphylococcus aureus (MRSA) carried out in 1995 and 1999,

the latter involving colleagues in Northern Ireland. There have been a number of

local surveys of antibiotic-resistant bacteria including the molecular

characterization of MRSA in Dublin hospitals, vancomycin-resistant enterococci,

and Gram-negative bacteria such as Enterobacter spp. and Serratia spp. affecting

compromised patients such as bone marrow transplant recipients. In the future, it

is hoped to standardize case definitions, automate data entry, increase

collaboration with surveillance initiatives in Northern Ireland and link in with

European networks such as EARSS and HELICS. Apart from the need to improve the

quality of health care in Irish hospitals, approximate costings suggest that

there are potential savings of 7.5 pounds sterling -15 pounds sterling m to be

made following a reduction of HAI rates of 15%.

Copyright 2001 The Hospital Infection Society.

PMID: 11516190 [PubMed - indexed for MEDLINE]