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What are the Roles of Carbapenems, in an Institution Specific Epidemiological Antibiogram, in East Trinidad?



Objectives: This document provides an overview of the development of an institution specific epidemiological antibiogram. Emphasis was on last line antibiotics, such as carbapenems.    

Methods: Antibiograms, for the year 2013, of various organisms were retrieved from the computerized database of the Microscan© [Siemens Healthcare] at the microbiology laboratory, of the Sangre Grande Hospital in East Trinidad, West Indies. This was divided into blood and urine specimen antibiograms. All wards and hospital clinics were included. A twenty [20] percent [%], cut off was used to determine that a particular antibiotic or antibiotic class could be used for empiric therapy. All organisms were not chosen. Only the most common and clinically relevant were chosen.              

Results: Blood: Escherichia coli, Klebsiella pneumonia,Proteus mirabilis: Imipenem, meropenem, ertapenem showed greater than 80% sensitivity, respectively. Pseudomonas aeruginosa: ceftazidime, ciprofloxacin, gentamicin, levofloxacin and tazobactam/piperacillin showed 100%, 80%, 80%, 100% and 100% sensitivity, respectively. Urines: Escherichia coli, Klebsiella pneumoniaProteus mirabilis: Imipenem, meropenem, ertapenem, were greater than 80 % sensitive. Enterobacter cloacae: Imipenem, meropenem were 92%, 100% sensitive. Pseudomonas aeruginosa: tazobactam-piperacillin and amikacin were both 85% susceptible. Acinetobacter baumanii/haemolyticus: All antibiotics were above the 20 % resistance threshold.

Conclusion: Patient specific antibiograms and unit specific trends [e.g. ICU, surgical wards, and outpatient clinic] can be used as a guide in patients with less severe infections. Carbapenems can still be used empirically, in east Trinidad, for sepsis.

18 May, 2015
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e-Published: 10 Nov, 2015


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