Laboratory testing policies and their effects on routine surveillance of community antimicrobial resistance

Objective: To investigate the effects of laboratory testing policies, particularly selective testing, rule-based reporting and isolate identification, on estimates of community antimicrobial resistance. Materials and methods: Antibiotic resistance estimates were analysed from an all-Wales dataset fo...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2004-06, Vol.53 (6), p.1010-1017
Main Authors: Heginbothom, Margaret L., Magee, J. T., Bell, Joanna L., Dunstan, F. D. J., Howard, A. J., Hillier, Sharon L., Palmer, S. R., Mason, B. W.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - pharmacology
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacterial Infections - drug therapy
Bacterial Infections - epidemiology
Bacterial Infections - microbiology
Biological and medical sciences
community isolates
Drug Prescriptions
Drug Resistance, Bacterial
Enterobacteriaceae
Escherichia coli
Humans
Laboratories - standards
Medical sciences
Microbial Sensitivity Tests - standards
Pharmacology. Drug treatments
Population Surveillance - methods
Public Policy
resistance estimates
Urinary Tract Infections - microbiology
Wales - epidemiology
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Summary:Objective: To investigate the effects of laboratory testing policies, particularly selective testing, rule-based reporting and isolate identification, on estimates of community antimicrobial resistance. Materials and methods: Antibiotic resistance estimates were analysed from an all-Wales dataset for approximately 300 000 community isolates of common pathogens. Results: Selective testing policies were often associated with markedly increased resistance, particularly for second-line testing. Site-specific testing tended to yield variant resistance estimates for eye and ear isolates. Estimates from rule-based reporting deviated markedly from test-result-based reporting. Urinary isolates reported as Escherichia coli showed greater susceptibility than those reported as undifferentiated urinary ‘coliforms’. The proportion of isolates tested for an antibiotic by a laboratory was a useful indicator of selective testing in this dataset. Selective testing policies had invariably been applied where the proportion of isolates of a species tested against an antibiotic was
ISSN:0305-7453
1460-2091
1460-2091
DOI:10.1093/jac/dkh229