Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Sepsis Outcome Programme (AESOP) Annual Report 2017

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Coombs, Geoffrey W
Daley, Denise A
Lee, Yung Thin
Pang, Stanley
Collignon, Peter
Bradbury, Susan
Gottlieb, Thomas
Robertson, Graham
Branley, James
Barbaro, Donna
Huntington, Peter
van Hal, Sebastiaan
Beukers, Alicia
Iredell, Jon
Ginn, Andrew
Givney, Rod
Winney, Ian
Newton, Peter
Hoddle, Melissa
Harkness, Jock
Lorenz, David
Baird, Rob
Hennessy, Jann
McLeod, James
Binotto, Enzo
Thomsett, Bronwyn
Nimmo, Graeme
et al.
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2019
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Abstract

From 1 January to 31 December 2017, 36 institutions around Australia participated in the Australian Enterococcal Sepsis Outcome Programme (AESOP). The aim of AESOP 2017 was 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 1,137 unique episodes of bacteraemia investigated, 95.2% were caused by either E. faecalis (52.9%) or E. faecium (42.3%). Ampicillin resistance was not detected in E. faecalis but in 89.6% of E. faecium. Vancomycin non-susceptibility was reported in 0.3% and 47.0% of E. faecalis and E. faecium respectively. Overall 50.9% of E. faecium harboured vanA or vanB genes. For the vanA/B positive E. faecium isolates, 49.6% harboured vanB genes and 49.2% vanA genes; 1.2% harboured vanA and vanB genes. The percentage of E. faecium bacteraemia isolates resistant to vancomycin in Australia is significantly higher than that seen in most European countries. E. faecium consisted of 76 multilocus sequence types (STs) of which 77% of isolates were classified into nine major STs containing ten or more isolates. All major STs belong to clonal cluster (CC) 17, a major hospital-adapted polyclonal E. faecium cluster. Seven of the nine predominant STs (ST80, ST1421, ST17, ST296, ST555, ST203 and ST18) were found across most regions of Australia. The most predominant clone was ST17 which was identified in all regions except the Australian Capital Territory, the Northern Territory and Tasmania. Overall 60.7% of isolates belonging to the nine predominant STs harboured vanA or vanB genes. The AESOP 2017 has shown enterococcal bacteraemias in Australia are frequently caused by polyclonal ampicillin-resistant high-level gentamicin resistant vanA or vanB E. faecium which have limited treatment options.

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Communicable Diseases Intelligence

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43

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© 2019 Commonwealth of Australia as represented by the Department of Health/ This publication is licensed under a Creative Commons Attribution- Non-Commercial NoDerivatives 4.0 International Licence from https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode (Licence). You must read and understand the Licence before using any material from this publication.

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Clinical sciences

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Life Sciences & Biomedicine

Infectious Diseases

Australian Group on Antimicrobial Resistance (AGAR)

antimicrobial resistance surveillance

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Coombs, et al., Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Sepsis Outcome Programme (AESOP) Annual Report 2017, Communicable Diseases Intelligence, 2019, 43

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