P-148. A Practical Antibiogram for Community-Acquired Gastroenteritis in British Columbia, Canada

TL;DR

This study creates a practical antibiogram for common gastrointestinal pathogens in British Columbia to guide antibiotic treatment choices.

Contribution

The novel contribution is generating a region-specific antibiogram for community-acquired gastroenteritis pathogens in British Columbia.

Findings

Multidrug-resistant Salmonella species are not currently a significant issue in British Columbia.

Choosing effective oral antibiotics for Shigella species is challenging due to low susceptibility rates (<50%).

Azithromycin may be a reasonable treatment for Salmonella and Vibrio infections, though data is limited.

Abstract

Hospital microbiology laboratories do not routinely allow testing for community gastrointestinal stool pathogens in hospitalized patients who develop diarrhea after day 3 of hospitalization. In contrast, community microbiology laboratories routinely test and collect data of gastrointestinal stool pathogens, including their antimicrobial susceptibility profiles. The current study aimed to generate a practical antibiogram based on bacterial stool culture and susceptibility results collected in regional community microbiology laboratories in British Columbia (BC), Canada.

LifeLabs BC microbiology laboratories, connected with 129 collection centres in urban and rural communities in the province, provided the laboratory data for the fecal bacterial pathogens. An audit was conducted from January 1, 2020 to December 31, 2023. Calculations were performed as per the Clinical and Laboratory Standards Institute M39 document (2022).

ORGANISMAmpicillinTrimethoprim-SulfamethoxazoleCiprofloxacinTetracyclineAzithromycinCeftriaxoneAeromonas species, % susceptibleR96999998n =677664664774Campylobacter jejuni/coli, % susceptibleRR5565100n =555559Salmonella species#, % susceptible919485@99n =326292318338Shigella species, % susceptible1912213191n =243225230113243Vibrio species, % susceptibleR9710097@n =323737Yersinia species, % susceptibleR1009999100n =822878927980R = The organism is intrinsically resistant to the antibiotic indicated OR is not recommended due to poor clinical response and/or poor activity@ = Azithromycin may be a reasonable treatment option for Salmonella and Vibrio infections when clinically indicated; however, LifeLabs has not tested enough isolates to generate a meaningful antibiogram.

R = The organism is intrinsically resistant to the antibiotic indicated OR is not recommended due to poor clinical response and/or poor activity

@ = Azithromycin may be a reasonable treatment option for Salmonella and Vibrio infections when clinically indicated; however, LifeLabs has not tested enough isolates to generate a meaningful antibiogram.

Multidrug and extended-drug resistant Salmonella species do not appear to be a current problem in British Columbia. Choosing the optimal oral antimicrobial agent for Shigella species is a challenge as sensitivities of oral agents were < 50%.

All Authors: No reported disclosures