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Enterococci
Enterococci
After years of steady state, vancomycin resistance in enterococci (VRE) has increased since 2018.
Enterococci belong to the intestinal flora and are of low pathogenicity. However, especially in the hospital environment they can cause severe infections. Numbers of VRE in Switzerland remained stable until 2018, when several outbreaks including one of the ST 796 clone (see literature) caused a considerable increase. Subsequently, recommendations to contain VRE spread in health care facilities were published by Swissnoso, current cantonal VRE data are updated monthly (see graphic below).
Enterococcus faecalis
Select a region of interest, a unit, an antibiotic or a year of choice from the drop-down menus. Use the checkboxes to activate or deactivate time series and confidence intervals. When the mouse is moved over the graph a toolbar appears, which allows zooming, showing data on hover and downloading of the graph.
95% CI: 95% confidence interval
For this analysis invasive isolates (blood and cerebrospinal fluid) tested against the corresponding antibiotic (category) were considered only. If multiple antibiotics within the same antibiotic category were tested, the most resistant result was selected. In case of multiple isolates, the first isolate per patient, microorganism and calendar year was included only. Results are reported as delivered by laboratories. Statistics may be influenced by the changing number of laboratories participating. Data are provided for surveillance purposes and are not intended to be used for therapeutic decisions solely.
Enterococcus faecium
Select a region of interest, a unit, an antibiotic or a year of choice from the drop-down menus. Use the checkboxes to activate or deactivate time series and confidence intervals. When the mouse is moved over the graph a toolbar appears, which allows zooming, showing data on hover and downloading of the graph.
95% CI: 95% confidence interval
For this analysis invasive isolates (blood and cerebrospinal fluid) tested against the corresponding antibiotic (category) were considered only. If multiple antibiotics within the same antibiotic category were tested, the most resistant result was selected. In case of multiple isolates, the first isolate per patient, microorganism and calendar year was included only. Results are reported as delivered by laboratories. Statistics may be influenced by the changing number of laboratories participating. Data are provided for surveillance purposes and are not intended to be used for therapeutic decisions solely.
Current numbers of VRE isolates per canton
New VRE cases half-yearly and per canton. Only hospitalized patients are considered, doubles (same patients) are excluded. In case of multiple samples per patient, the most invasive sample is considered. Screening samples are defined as sample locations “anal”, “faeces”, “intact skin” or “mucosa-swab”.
Current numbers of VRE isolates per canton
New VRE cases half-yearly and per canton. Only hospitalized patients are considered, doubles (same patients) are excluded. In case of multiple samples per patient, the most invasive sample is considered. Screening samples are defined as sample locations “anal”, “faeces”, “intact skin” or “mucosa-swab”.
To activate / deactivate a sample type click on the icons in the legend. When the mouse is moved over the graph a toolbar appears, which allows zooming, showing data on hover and downloading of the graph.
VRE: Vancomycin-resistant enterococci
year_1 and year_2: First (January-June) and second (July-December) six months of the year
From every patient the most invasive isolate which was sampled within one calendar year was included. Results are reported as delivered by laboratories. Results may be influenced by the changing number of laboratories participating.
Links / literature:
Swiss Antibiotic Resistance Report 2022. Chapter 7.6. Enterococci
Eindämmung der Verbreitung von Vancomycin-resistenten Enterokokken (VRE) in der Schweiz: Aktualisierung der nationalen Empfehlungen. Version 2.0 Dez. 2019
Emergence of vancomycin-resistant enterococci in Switzerland: a nation-wide survey.
Emergence of vancomycin-resistant enterococci in Switzerland: a nation-wide survey.
Outbreak of vancomycin-resistant Enterococcus faecium clone ST796, Switzerland, December 2017 to April 2018.
Outbreak of vancomycin-resistant Enterococcus faecium clone ST796, Switzerland, December 2017 to April 2018
Euro Surveill. 2018 Jul;23(30)
Increasing proportion of vancomycin resistance among enterococcal bacteraemias in Switzerland: a 6-year nation-wide surveillance, 2013 to 2018
Klebsiella pneumoniae
Klebsiella pneumoniae
The resistance rate to 3rd/4th generation cephalosporins steadily increased from 2004 to 2014, but stabilized since then.
Equally to E. coli, Klebsiella pneumoniae, belong to the family of Enterobacteriales and are potentially causing urinary tract infections. In addition, they are known to cause pneumonia, particularly in the hospital setting. The resistance rate in K. pneumoniae to 3rd/4th generation cephalosporins increased from 1% in 2004 to 9.2% in 2014, which was comparable to the increase in E. coli. However, rates of 3rd/4th generation cephalosporin resistant K. pneumoniae remained constant during the last ten years.
Patients with a K. pneumoniae infection in the hospital setting are generally isolated, due to an increased risk of transmission.
Select a region of interest, a unit, an antibiotic or a year of choice from the drop-down menus. Use the checkboxes to activate or deactivate time series and confidence intervals. When the mouse is moved over the graph a toolbar appears, which allows zooming, showing data on hover and downloading of the graph.
95% CI: 95% confidence interval
For this analysis invasive isolates (blood and cerebrospinal fluid) tested against the corresponding antibiotic (category) were considered only. If multiple antibiotics within the same antibiotic category were tested, the most resistant result was selected. In case of multiple isolates, the first isolate per patient, microorganism and calendar year was included only. Results are reported as delivered by laboratories. Statistics may be influenced by the changing number of laboratories participating. Data are provided for surveillance purposes and are not intended to be used for therapeutic decisions solely.
Links / literature:
Swiss Antibiotic Resistance Report 2022. Chapter 7.2. Klebsiella pneumoniae
Enterobacteriaceae mit Breitspektrum Beta-Laktamasen (ESBL) im Spital: Neue Empfehlungen Swissnoso 2014.
Temporal trends of extended-spectrum cephalosporin resistant Escherichia coli and Klebsiella pneumoniae in Switzerland.
Transmission dynamics of extended-spectrum β-lactamase-producing Enterobacteriaceae in the tertiary care hospital and the household setting
Neisseria gonorrhoeae
Neisseria gonorrhoeae
Increased resistance rates are observed for this sexually transmitted bacterium.
Infections with gonococci are steadily increasing. They are often observed in combination with other sexually transmitted diseases such as chlamydia, HIV, Hepatitis B or Syphilis. Although resistance rates to cephalosporines and azithromycin are increasing, ceftriaxone still is the first line therapy, but should be used in higher doses in order to prevent the development of new resistances (see SSI guidelines). Nowadays, urine samples containing gonococci are mainly genetically analysed using polymerase chain reaction (PCR). By this approach resistance results are not available which leads to the fact, that the resistance situation in Switzerland can’t be described appropriately. Therefore, it is suggested to culture the bacteria in case of a gonococcal infection.
Links / literature:
Swiss Antibiotic Resistance Report 2022. Textbox Neisseria gonorrhoeae
Swiss gonorrhoeae infection data (German):
General information on sexually transmitted diseases: Love-life
Swiss AIDS Federation
Guideline Swiss Society for Infectious Diseases
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