2004 Wyoming Antibiotic Resistance Report Streptococcus pneumoniae by variablepitch334

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									Volume 10, Number 2, March – April 2005

2004 Wyoming Antibiotic Resistance Report Streptococcus pneumoniae Streptococcus pneumoniae is a leading cause of meningitis, pneumonia, blood stream infections and otitis media in children. Increasingly, drug resistant infections caused by Streptococcus pneumoniae complicate treatment options. To better understand the demographics of Drug-Resistant Streptococcus pneumoniae (DRSP) in Wyoming, a sentinel surveillance system was expanded to include 13 sites from 10 different counties. Laboratories were selected based on their uniform testing methodology which allowed the Wyoming Department of Health to create a composite susceptibility profile. The population under surveillance is approximately 75% of the total Wyoming population. The surveillance case definition is any Streptococcus pneumoniae isolated from a sterile or non-sterile site. DRSP is defined as Streptococcus pneumoniae resistant to one or more commonly used antibiotics approved to treat Streptococcus pneumoniae. Below is a graphical summary of data obtained from the 13 Wyoming surveillance sites. For more information on the Centers for Disease Control and Prevention’s Active Bacterial Core Surveillance Data, please visit http://www.cdc.gov/ncidod/dbmd/abcs/survreports/spneum03.pdf. Figure 1
The Number of Streptococcus pneumoniae Isolates Tested by 13 Sentinel Surveillance Sites
120
2004 2003

N m e oI o t s u b r fs l e a

100 80 60 40 20 0 1 2 3 4 5 6 7 8 9 10 11 12 13

Isolates from sterile and non-sterile sites.

Surveillance Site

Figure 2
The % of Streptococcus pneumoniae Isolates Non-Susceptible to Penicillin By Sentinel Surveillance Site 70% % Non-Susceptible 60% 50% 40% 30% 20% 10% 0% 1 2 3 4 5 6 7 8 9 10 11 12 13
2004 2003

** Refer to Figure 1 for the number of isolates Graph represents isolates from sterile and nonsterile sites. 2003 Median = 29% 2004 Median = 44.40% Mean= 30.5% Mean = 37.8% Range = 0.0-65.4% Range = 0.0-66%

Surveillance Site

Figure 3
The % of Streptococcus pneumoniae Isolates Non-Susceptible to Cefotaxime or Ceftriaxone by Sentinel Surveillance Site 40% Susceptible % Non 30% 20% 10% 0% 1 2 3 4 5 6 7 8 Surveillance Site 9 10 11 12 13
2004 2003

** Refer to figure 1for the number of isolates 2003 Median = 0% 2004 Median = 0% Mean = 6.6% Mean = 8.3% Range = 0.00 - 34.5% Range = 0.0-28.10%

Figure 4
Susceptibility Profile Comparison of Wyoming Streptococcus pneumoniae Isolates to CDC's 2003 Active Bacterial Core Surveillance Data (ABCs)*
40% 35% 30% 25% 20% 15% 10% 5% 0%
37.60% 37.80%

%Non-Susceptible

20.00% 8.90% 12.00% 3.10%
Pen WY 2004 Pen WY 2003 Pen ABC's 2003 Cefo/Ceftri WY 2004 Cefo/Ceftri WY 2003 Cefo ABC's 2003

0.01%
Levo WY 2004

0.00%
Levo WY 2003

0.40%
Levo ABC's 2003

Antibiotic
*ABC’s data only includes isolates from sterile site infections which have been shown in some studies to be more susceptible than non-invasive Streptococcus pneumoniae. Wyoming’s Sentinel Surveillance System includes both invasive and non-invasive isolates.

2004 Composite Susceptibility Profile of S. pneumoniae Isolates From 13 Sentinel Surveillance Sites in Wyoming
Antibiotic Susceptibility Penicillin* Cefotaxime or Ceftriaxone* Levofloxacin° S % 62.4 91.1 99.9 I % 14.9 2.0 0.0 R %_ 22.8 6.9 0.01 % Non-Susceptible (I+R) 37.6 8.9 0.01

2003 Composite Susceptibility Profile of S. pneumoniae Isolates From 13 Sentinel Surveillance Sites in Wyoming
Antibiotic S Susceptibility % Penicillin* 62.2 Cefotaxime or 88 Ceftriaxone* Levofloxacin° 100 I % 11.1 1.8 0.0 R %_ 26.7 10.2 0.0 % Non-Susceptible (I+R) 37.8 12.0 0.0

Susceptible, Intermediate and Resistant based on 2002 NCCLS definitions. *Based on 303 isolates tested. °Based on 134 isolates tested

Susceptible, Intermediate and Resistant based on 2002 NCCLS definitions. *Based on 332 isolates tested. °Based on 112 isolates tested.

Conclusions Overall, there were 29 fewer Streptococcus pneumoniae isolates reported by the 13 sentinel surveillance sites in 2004. rd Isolates non-susceptible to penicillin declined by 0.2% in 2004. Resistance to the 3 generation cephalosporins is down 3.1%. Resistance to the fluoroquinilone Levofloxacin has been reported for the first time in three isolates. Several sites saw decreases in the total number of isolates as well as a decrease in resistance. At the same time, several sites saw increases in total isolates and an increase in the number of drug-resistant infections caused by Streptococcus pneumoniae.

Wyoming Morbidity Report1
Year to Date 9 1 30 3 4 1 3 366 2 1 1 1 3 1 1 5 2 3 1 2 5 1 7 1 1 6 1 1 9 3 4 4 1 1 2 1 1 6 17 1 3 39 0 1
4

Hot Springs

Sweetwater

Converse

Campbell

Washakie

Big Horn

Johnson

Fremont

Sheridan

Niobrara

Sublette

Laramie

Natrona

January - April 2005 Albany

Campylobacter Chlamydia Cryptosporidiosis Cytomegalovirus E. coli non-O157:H7 Giardiasis Gonorrhea Haemophilus influenzae Hepatitis B, carrier Hepatitis C, chronic HIV Disease (HIV/AIDS) Lead Level, blood, elevated: Adult
3 2

2 16 11 27 2 3

1 5 1 37 4 1

1 2

1 118 2 66

2 14

1 1

1 16

1.6% 65.4% 0.4% 0.2% 0.2% 1.1% 3.0% 0.2% 0.5% 7.0% 0.0% 2.5% 0.2% 0.4% 0.2% 0.4% 1.8% 0.2% 1.6% 0.2% 1.8% 0.5% 0.2% 2.7% 0.4% 0.7% 7.0%

1 1 1 1 1

1

10

1

14 1 2 1

Children Legionellosis Malaria Meningitis, other Pertussis Q Fever Rabies, animal Rocky Mountain Spotted Fever Salmonellosis Streptococcal Infection, Grp A or B, invasive Steptococcal Infection, nonA/nonB Streptococcus pneumoniae, drug resistant Streptococcus pneumoniae, drug susceptible Vancomycin-Resistant Enterococcus Varicella (Chickenpox) Total Percent 22 2 14 1 1 1

1 2 1 2 1 2 2 1 4 3 1 18 47 24 8 1 51 9 1 9 141 1 1 1 4 2 5 5 100 0 11 30 3 30 1 41 4 1 13 3 6 1 2 1 1 1 4 1 5 2

1

2 10 1 9 1 10 3 1 15 2 4 39

3

3

560 100.0%

3.9% 2.5% 8.4% 4.3% 1.4% 0.2% 9.1% 1.6% 0.2% 1.6% 25.2% 0.9% 17.9% 0.0% 5.4% 0.5% 5.4% 0.2% 7.3% 0.7% 2.3% 0.5% 0.5%

Data contained in this informational release was compiled in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and the Preventive Health and Safety Division Data Release Policy. To protect patient confidentiality, no individually identifiable information that could be linked to a single case of reportable disease has been disclosed. 1 Provisional data as some cases are under investigation. Confirmed (NETSS status 1) and probable (NETSS status 2) cases only. Only diseases with reported incidence are shown. At the time of this publication, 128 cases of disease remain classified as unconfirmed and are not shown in the table above. 2 nd th HIV/AIDS data released 2 & 4 quarters only. Data represent newly identified infections and HIV cases from other states reclassified as Wyoming AIDS cases during this period. 3 Adults, > 24µg/dL 4 Children, > 10 µg/dL

% Year to Date

Goshen

Carbon

Weston

Lincoln

Crook

Platte

Teton

Uinta

Park

Brent D. Sherard, M.D., M.P.H., Interim Director Wyoming Department of Health Office: 307-777-7656
Dr. Brent Sherard, Interim Director/State Health Officer Linda Chasson, M.S., Administrator, PHSD Dr. Tracy Murphy, E.I.S. Officer/Interim State Epidemiologist Scott Seys, Infectious Disease Epidemiologist Dr. David Barber, Environmental Epidemiologist Dr. Joseph Grandpre, Chronic Disease Epidemiologist Office 307-777-6340 307-777-7958 307-777-7718 307-777-5596 307-777-8736 307-777-8654 Pager

307-772-3743 307-633-0503

Epidemiologists are available 24 hours a day at 1-888-996-9104. Providers can call this number for epidemiological, clinical, and laboratory consultation and assistance on any illness. This number can also be used to notify the Department of Health of a reportable disease, potential food/water-borne disease outbreak, suspected incident of bioterrorism, or any other health hazard.

Department of Health Preventive Health and Safety Division Hathaway Building, 4th Floor Cheyenne, WY 82002


								
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