Hong Kong West Cluster

1. Non-duplicate isolates from blood, urine and respiratory specimens. Interpreted according to CLSI M100-S28 2021. Nonsusceptible includes both intermediate & resistant.
2. Results for Enterobacteriaceae were interpreted according to CLSI M100-S28 2021. A total of 40 sporadic carbapenemase-producing Enterobacteriaceae (CPE) isolates were detected in 36 patients. The specimen sources include blood (n=9), respiratory (n=5), and urine (n=26). The 40 isolates produced NDM (n=26), OXA-48 (n=7), and KPC (n=7) types of carbapenemases.
3. Ho PL Int J Antimicrob Agents 2010;36:469 and J Hosp Infect 2010;74:358
4. Overall prevalence of extended-spectrum beta-lactamases (ESBL) was 22% for Klebsiella species and 28% for E. coli. ESBL-producing strains should be interpreted as resistant to all penicillins, cephalosporins and aztreonam.
5. In S. pneumoniae, resistance to azithromycin & clarithromycin can be predicted by testing erythromycin (CLSI M100-S28 2021).
6. Most had other risk factors such as past hospitalization and nursing home residence.
7. Ho PL J Antimicrob Chemo 2009;63:836
8. According to breakpoint for parenteral cefuroxime sodium.
9. Urine isolates only.
10. , indicate 10% or more reduction in resistance rate compared to 2020.
    
    , indicate ≥10% increase in resistance rate compared to 2020.
11. The figure refers to ACB complex, including Acinetobacter baumannii, Acinetobacter calcoaceticus, Acinetobacter nosocomialis, and Acinetobacter pittii.
12. Combined data from 2020(17) and 2021(22)

* Including MIC ≤ 0.06 (30.8%), MIC 0.09-1 (46.2%), MIC 1.5-2 (15.4%), MIC 3-6 (5.1%), MIC 8 (2.6%)
% Penicillin sensitive: meningitis breakpoint at MIC ≤0.06 = 30.8% and non-meningitis breakpoint at MIC≤2 = 92.3%
Abbreviation: Amp, Ampicillin; Amo, Amoxicillin; Pip, Piperacillin; Tic, Ticarcillin; Cef, Cefoperazone