Abstract
The effect of duplicate isolate removal strategies on Staphylococcal aureus susceptibility to oxacillin was compared by using antimicrobial test results for 14,595 isolates from statewide surveillance in Hawaii in 2002. No removal was compared to most resistant and most susceptible methods at 365 days and to the National Committee for Clinical Laboratory Standards (NCCLS) and Cerner algorithms at 3-, 10-, 30-, 90-, and 365-day analysis periods. Overall, no removal produced the lowest estimates of susceptibility. Estimates with either NCCLS or Cerner differed by <2% when the analysis period was the same; with either method, the difference observed between a 90- and a 365-day period was <1%. The effect of duplicate isolate removal was greater for inpatient than outpatient settings. Considering the ease of implementation and comparability of results, we recommend using the first isolate of a given species per patient to calculate susceptibility frequencies for S. aureus to oxacillin.
Highlights
Analysis, to calculate susceptibility frequencies [7]
We evaluated the effects of 13 distinct duplicate isolate removal strategies on Staphylococcus aureus susceptibility to oxacillin by using antimicrobial susceptibility test results from a statewide antimicrobial resistance surveillance system in Hawaii
A total of 3,725 isolates were from 2,749 patients with an associated medical record number (MRN); 10,870 were from 8,143 patients identified with an assigned patient identifier (APID)
Summary
Analysis, to calculate susceptibility frequencies [7]. Other approaches currently in use include not removing any isolates, counting only the most susceptible or most resistant isolate from a patient per surveillance period, and applying the Cerner laboratory management system, a widely used software program [4]. Studies comparing the potential effect of using different methods for duplicate isolate removal are limited, i.e., most existing analyses are based on data from a single facility or compared only a few of the many different options for duplicate isolate removal [4,5,6]. We evaluated the effects of 13 distinct duplicate isolate removal strategies on Staphylococcus aureus susceptibility to oxacillin by using antimicrobial susceptibility test results from a statewide antimicrobial resistance surveillance system in Hawaii
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