JAC Advance Access published online on May 5, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh232
© 2004 by The British Society for Antimicrobial Chemotherapy
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1 Department of Medical
Microbiology, Southmead Hospital, Bristol BS10 5NB;
Objectives: To describe the current
patterns of antimicrobial resistance in the major pathogens of bacteraemia
in the UK and Ireland, to highlight any unexpected resistance patterns
and to act as a reference baseline for future studies. Methods: In 2001 and 2002, 5092 blood culture
isolates were collected by 29 laboratories distributed across the
UK and Ireland. A single central laboratory re-identified the isolates
and measured MICs by the BSAC agar dilution method. Results: Oxacillin resistance was found in 42% of Staphylococcus aureus and 76% of coagulase-negative staphylococci.
Streptococci were generally susceptible to Conclusion: Antimicrobial resistance among major
bloodstream pathogens to those antimicrobials often selected for
empirical therapy was relatively uncommon in 2001-2002,
usually <10%. An important exception was oxacillin
resistance in S. aureus.
Accepted March 9, 2004
Original article
Antimicrobial susceptibility of the pathogens of
bacteraemia in the
UK and Ireland 2001-2002: the BSAC Bacteraemia Resistance Surveillance
Programme
2 Antibiotic Resistance Monitoring & Reference
Laboratory, Health Protection Agency, 61 Colindale Avenue, London
NW9 5HT, UK
Abstract 
-lactams,
but tetracycline resistance was common (except in Streptococcus
pneumoniae) and particularly common among group B isolates
(82% resistant). Nine percent of S. pneumoniae had
reduced susceptibility to penicillin (MICs 0.12-1 mg/L),
but none required 
2 mg/L for inhibition.
High-level gentamicin resistance was seen in 43% of Enterococcus faecalis,
often in combination with raised ciprofloxacin MICs (32
mg/L), but these isolates remained susceptible to ampicillin and
imipenem. Only linezolid and tigecycline showed in vitro potency
against a large proportion of Enterococcus faecium.
Vancomycin resistance was restricted to enterococci (20% of
E. faecium, 3% of E.
faecalis) and a single isolate of coagulase-negative staphylococci
(0.2%, MIC of 8 mg/L). Escherichia coli isolates
were commonly resistant to amoxicillin (56%) and tetracycline
(88%) but remained susceptible to ceftazidime, piperacillin/tazobactam
and imipenem. Extended-spectrum -lactamases
were detected in 2% of E. coli (none in
2001, 3.2% in 2002), 5% of Klebsiella spp.
and 8% of Enterobacter spp. Resistance
rates of Pseudomonas aeruginosa to ciprofloxacin,
ceftazidime, gentamicin, imipenem and piperacillin/tazobactam were
between 4% and 7%. Among the newly licensed and
developmental agents, there was no resistance to linezolid in Gram-positive
organisms. Ertapenem had a wide spectrum, covering Enterobacteriaceae,
streptococci and oxacillin-susceptible staphylococci. MICs of tigecycline
were low for Gram-positive species and Enterobacteriaceae except
Proteeae and Enterobacter spp.
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