Sentinel Surveillance of Antibiotic Resistance in Switzerland (SEARCH)
Abstract number: P671
Kronenberg A., Mühlemann K., Schlegel M., Evison J.
Objectives: Comprehensive, representative and valid surveillance of antibiotic resistance on local, national and international levels is key to resistance control. We established a national surveillance programme in Switzerland within the frame of the National Research Program of Antibiotic Resistance (NRP49).
Methods: Routine resistance data are collected electronically on a weekly base from 22 clinical microbiology laboratories into a central data base. Data are validated, mapped to a common nomenclature and subjected to algorithms identifying double samples, defining microorganisms as contaminants versus pathogens and nosocomial versus community-acquired.
Results: In 2006 SEARCH received resistance data on 100,988 clinical isolates and 396 different bacterial species. The system represents approximately 80% of acute care hospital days and >30% of Swiss practitioners in the outpatient setting. Geographical distribution is even. 12.2% of samples derive from children <15 years of age and 4.6% from <2 years olds.
Isolates from sterile anatomical sites contribute 24% of all data. The relative distribution of hospital isolates was 24.6% from outpatient departments, 17.2% from surgery, 16.6% from internal medicine, 8.1% from intensive care units, 5.5% from paediatrics, 4.4% from obstetrics and gynaecology and 23.6% mixed or others. Among practitioners providing isolates the specialities were 30.4% general practitioners, 20.2% gynaecologists, 14.9% internal medicine, 7.6% paediatricians and 26.9% others.
In 2006, 2305 Swiss hospitalised patients experienced colonisation or infection by at least on of four prominent multi-resistant germs (MDR) (Meticillin-resistant S. aureus, extended-spectrum b-lactamase producers, multi-resistant P. aeruginosa and Acinetobacter spp.) and 15.2% of these had invasive infection. Attributable mortality was at least 80 deaths per year. Prevalence of MDR showed significant geographical differences with higher rates in South-West Switzerland (6.6%) compared to the Northeast (3.8%, p < 0.001).
Conclusion: The Swiss national system for antibiotic resistance surveillance provides a valuable tool for large scale, detailed and timely monitoring of antibiotic resistance in human medicine.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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