title: Australian Group on Antimicrobial Resistance Australian Staphylococcus aureus Sepsis Outcome Programme annual report, 2014.
abstract: From 1 January to 31 December 2014, 27 institutions around Australia participated in the Australian Staphylococcal Sepsis Outcome Programme (ASSOP). The aim of ASSOP 2014 was to determine the proportion of Staphylococcus aureus bacteraemia (SAB) isolates in Australia that are antimicrobial resistant, with particular emphasis on susceptibility to methicillin and to characterise the molecular epidemiology of the isolates. Overall, 18.8% of the 2,206 SAB episodes were methicillin resistant, which was significantly higher than that reported in most European countries. The 30-day all-cause mortality associated with methicillin-resistant SAB was 23.4%, which was significantly higher than the 14.4% mortality associated with methicillin-sensitive SAB (P <0.0001). With the exception of the beta-lactams and erythromycin, antimicrobial resistance in methicillin-sensitive S. aureus remains rare. However in addition to the beta-lactams, approximately 50‰ of methicillin-resistant S. aureus (MRSA) were resistant to erythromycin and ciprofloxacin and approximately 15% were resistant to co-trimoxazole, tetracycline and gentamicin. When applying the European Committee on Antimicrobial Susceptibility Testing breakpoints, teicoplanin resistance was detected in 2 S. aureus isolates. Resistance was not detected for vancomycin or linezolid. Resistance to non-beta-lactam antimicrobials was largely attributable to 2 healthcare-associated MRSA clones; ST22-IV [2B] (EMRSA-15) and ST239-III [3A] (Aus-2/3 EMRSA). ST22-IV [2B] (EMRSA-15) has become the predominant healthcare associated clone in Australia. Sixty per cent of methicillin-resistant SAB were due to community-associated (CA) clones. Although polyclonal, almost 44% of community-associated clones were characterised as ST93-IV [2B] (Queensland CA-MRSA) and ST1-IV [2B] (WA1). CA-MRSA, in particular the ST45-V [5C2&5] (WA84) clone, has acquired multiple antimicrobial resistance determinants including ciprofloxacin, erythromycin, clindamycin, gentamicin and tetracycline. As CA-MRSA is well established in the Australian community it is important that antimicrobial resistance patterns in community and healthcare-associated SAB is monitored as this information will guide therapeutic practices in treating S. aureus sepsis.
authors: Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia.|Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine-WA, Fiona Stanley Hospital, Murdoch, Western Australia.
authors: Geoffrey W
authors: GW
authors: Coombs
authors: Australian Group on Antimicrobial Resistance, Fiona Stanley Hospital, Murdoch, Western Australia.
authors: Denise A
authors: DA
authors: Daley
authors: Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia.
authors: Yung
authors: Y
authors: Thin Lee
authors: Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine-WA, Fiona Stanley Hospital, Murdoch, Western Australia.
authors: Julie C
authors: JC
authors: Pearson
authors: Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia.|Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine-WA, Fiona Stanley Hospital, Murdoch, Western Australia.
authors: J Owen
authors: JO
authors: Robinson
authors: Division of Microbiology, Pathology Queensland Central Laboratory, Queensland.|Griffith University School of Medicine, Gold Coast, Queensland.
authors: Graeme R
authors: GR
authors: Nimmo
authors: Department of Microbiology and Infectious Diseases, The Canberra Hospital, Australian Capital Territory.|School of Clinical Medicine, Australian National University, Australian Capital Territory.
authors: Peter
authors: P
authors: Collignon
authors: Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Doherty Institute for Infection and Immunity, Victoria.
authors: Benjamin P
authors: BP
authors: Howden
authors: SA Pathology, Department of Microbiology and Infectious Diseases, Women's and Children's Hospital, North Adelaide, South Australia.
authors: Jan M
authors: JM
authors: Bell
authors: SA Pathology, Department of Microbiology and Infectious Diseases, Women's and Children's Hospital, North Adelaide, South Australia.|Departments of Pathology, Paediatrics and Molecular and Biomedical Sciences, University of Adelaide, Adelaide, South Australia.
authors: John D
authors: JD
authors: Turnidge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000847:Annual Reports as Topic; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001315:Australia / Q000453:epidemiology; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections; D003428:Cross Infection; D024881:Drug Resistance, Bacterial; D005260:Female; D049674:History, 21st Century; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011159:Population Surveillance; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000266:history / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents