Resistance Pattern of Common Bacterial

Isolates at Capitol University Medical

Center (CUMC) from January to
December 2019

Vincent F. Tatoy, M.D.

 Introduction
• Antimicrobial resistance (AMR)
– is the ability of organisms that cause disease to
withstand attack by antimicrobials

Center for Disease Control and Prevention: National Center for Infectious Diseases and World Health Organization:
Department of Communicable Disease Surveillance and Response, Manual for the Laboratory Identification and
Antimicrobial Susceptibility Testing of Bacterial Pathogens of Public Health Importance in the Developing World, Geneva:
World Health Organization, 2003.
• World Health Organization:
– Antimicrobial Resistance (AMR) is an increasingly
serious threat to global public health
• Patients who develop resistant infections
– higher cost for health care as compared to non-
resistant infections
– longer duration of illness
– additional tests and use of more expensive drugs
• Hospital antibiogram
– is a periodic summary of antimicrobial
susceptibilities of local bacterial isolates submitted
to the hospital’s clinical microbiology laboratory

S. Joshi. Hospital Antibiogram: A Necessity. Indian Journal of Medical Microbiology, 2010

Oct-Dec(4):227-80.
• Hospital Antibiogram
– an aid in selecting the most appropriate empiric
antibiotic therapy
– in monitoring of resistance trends over time
within an institution
– assess local susceptibility rates
– compare susceptibility rates of bacterial isolates
across institutions
• Recommendation by the World Health
Organization (WHO) Working Group on the
Regional Information Network on
Antimicrobial Resistance that a surveillance
program be initiated
•  Philippine Committee on Antimicrobial
Resistance Surveillance Program was created
in 1988 by the Department of Health’s
Department Order 339-J
• The development of hospital antibiogram is
also one of the core components of the
National Antimicrobial Stewardship (AMS)
program
• Methicilllin resistance was observed among
Staphylococcus aureus isolates at 53%
(n=6,675)
• High rates of multi-drug resistance among
common pathogens such as Escherichia coli,
Klebsiella pneumoniae, Pseudomonas
aeruginosa and Acinetobactaer baumannii
• One important factor that can be considered in
development of antimicrobial resistance is
previous exposure to antimicrobials
• Antimicrobial prescribing practices may vary
significantly across different hospital types and
be influenced by the types of patients admitted
and the resources available

Cotta M.O., Chen C., Tacey M., James R.S., Buising K.L., Marshall C., Thursky, K.A., What are the Similarities and Differences
in Antimicrobial Prescribing Between Australian Public and Private Hospital, Royal Australian College of Physicians, 2016.
 Objectives:
• General Objectives:
– To determine the characteristics of common
bacterial isolates from CUMC microbiology
laboratory from January to December 2019
 Objectives:
Specific objectives:
1. To identify the most common bacterial isolates from
different specimen sources and their resistance and
sensitivity to antibiotics
2. To determine the risk factors for development of
antimicrobial resistance among the top isolates.
3. Compare the antimicrobial resistance of isolates at CUMC
to reported by ARSP of the Philippines.
4. Give recommendations on empiric antibiotic coverage
based on the antimicrobial resistance/sensitivity pattern.
 Methodology
• Methodology including data analysis will be
patterned from the ARSP 2018 report
 Methodology
Clinical specimens of aerobic bacteria
submitted to clinical laboratory of CUMC from
January to December 2019 will be collected

Isolates will be categorized according to the

source of specimen such as blood, urine,
sputum

culture and antimicrobial susceptibility test

results will be encoded using a database
software called WHONET
 Data Analysis
• Analysis will be restricted to the first isolate
received (per genus under surveillance) per
patient in the calendar year
• Data are expressed as a cumulative resistance
percentage, i.e. the percentage of resistant
isolates out of all isolates with antimicrobial
susceptibility testing (AST) information on that
specific organism-antimicrobial agent
combination.
• For selected analyses, a 95% confidence
interval is determined for the resistance
percentage
• Cumulative percentages of resistance are
compared as proportions using the Chi-square
or Fisher’s test, using a p value of <0.05 as
statistically significant. Only species with
testing data for 30 or more isolates are
included in the analysis
• Thank you..