Australian Enterococcal Sepsis Outcome Progamme, 2011.
From 1 January to 31 December 2011, 29 institutions around Australia participated in the Australian Enterococcal Sepsis Outcome Programme (AESOP). The aim of AESOP 2011 was to determine the proportion of enterococcal bacteraemia isolates in Australia that are antimicrobial resistant, with particular emphasis on susceptibility to ampicillin and the glycopeptides, and to characterise the molecular epidemiology of the Enterococcus faecalis and E. faecium isolates. Of the 1,079 unique episodes of bacteraemia investigated, 95.8% were caused by either E. faecalis (61.0%) or E. faecium (34.8%). Ampicillin resistance was detected in 90.4% of E. faecium but not detected in E. faecalis. Using Clinical and Laboratory Standards Institute breakpoints (CLSI), vancomycin non-susceptibility was reported in 0.6% and 31.4% of E. faecalis and E. faecium respectively and was predominately due to the acquisition of the vanB operon. Approximately 1 in 6 vanB E. faecium isolates however, had an minimum inhibitory concentration at or below the CLSI vancomycin susceptible breakpoint of ≤ 4 mg/L. Overall, 37% of E. faecium harboured vanA or vanB genes. Although molecular typing identified 126 E. faecalis pulsed-field gel electrophoresis (PFGE) pulsotypes, more than 50% belonged to 2 pulsotypes that were isolated across Australia. E. faecium consisted of 73 PFGE pulsotypes from which 43 multilocus sequence types were identified. Almost 90% of the E. faecium were identified as clonal complex 17 clones, of which approximately half were characterised as sequence type 203, which was isolated Australia-wide. In conclusion, the AESOP 2011 has shown that although polyclonal, enterococcal bacteraemias in Australia are frequently caused by ampicillin-resistant vanB E. faecium.
Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Biomedical Sciences, Curtin University, Perth, Western Australia and Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, WA, Royal Perth Hospital, Perth, Western Australia.
Geoffrey W
GW
Coombs
Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, WA, Royal Perth Hospital, Perth, Western Australia.
Julie C
JC
Pearson
Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Biomedical Sciences, Curtin University, Perth, Western Australia.
Tam
T
Le
Australian Group on Antimicrobial Resistance, Royal Perth Hospital, Perth, Western Australia.
Denise A
DA
Daly
Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Biomedical Sciences, Curtin University, Perth, Western Australia and Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, WA, Royal Perth Hospital, Perth, Western Australia.
James O
JO
Robinson
Department of Microbiology and Infectious Diseases, Concord Hospital, Concord, New South Wales.
Thomas
T
Gottlieb
Microbiology Department, Austin Health, Heidelberg, Victoria and Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria.
Benjamin P
BP
Howden
Microbiology Department, Austin Health, Heidelberg, Victoria.
Paul D R
PD
Johnson
Population Health, Deakin University, Melbourne.
Catherine M
CM
Bennett
Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria.
Timothy P
TP
Stinear
SA Pathology, Department of Microbiology and Infectious Diseases, Women's and Children's Hospital, North Adelaide, South Australia and Departments of Pathology, Paediatrics and Molecular and Biomedical Sciences, University of Adelaide, Adelaide, South Australia.
John D
JD
Turnidge
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001315:Australia / Q000453:epidemiology; D016983:Enterococcus / Q000145:classification / Q000187:drug effects / Q000235:genetics; D005838:Genotype; D049674:History, 21st Century; D006801:Humans; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology* / Q000266:history / Q000382:microbiology*
D000900:Anti-Bacterial Agents