Carbapenem resistance in Gram-negative bacteria is an increasing problem across Wales and the World, resulting in treatment failures and contributing a significant risk to the patient. Third generation cephalosporin (3GC) resistance in Gram-negative bacteria drives carbapenem use and may contribute to increasing levels of resistance.
It is therefore important to determine the levels of 3GC resistance in Gram-negative bacteria; every 5 years SACU will collect a cross section of 3GC resistant Enterobactericeae strains isolated in Welsh laboratories and investigate the mechanisms of resistance.
In 2008 and 2014 SACU collected approximately 1/6th of all 3GC resistant Enterobacteriaceae across Wales. Details of the 2008 and 2014 collection can be seen in the reports below. We are currently collecting strains isolated during 2020 to 2021. Next collection is likely to be 2025 to 2026.
Report targeted surveillance for 3rd generation cephalosporin resistance in Wales:
3rd Generation Cephalosporin Resistance in Wales 2008 (Sept 2010)
3rd Generation Cephalosporin Resistance in Wales 2014 (Oct 2020)
We would like to continue our surveillance of 3rd generation cephalosporin resistance in Wales by asking all laboratories to submit the following isolates to SACU:
| Hospital Location | No. Requested | Hospital E.coli | Hospital Coliform | GP E.coli | GP Coliform |
| Bronglais Hospital, Aberystwyth | 32 | 6 | 4 | 17 | 5 |
| Royal Gwent, Newport (incl. Royal Glamorgan) | 196 | 39 | 62 | 54 | 41 |
| UHW, Cardiff | 169 | 48 | 29 | 68 | 24 |
| Singleton, Swansea | 226 | 25 | 90 | 27 | 84 |
| WWGH, Carmarthen | 129 | 26 | 30 | 36 | 37 |
| Ysbyty Glan Clwyd, Rhyl (incl Maelor & Bangor) | 259 | 62 | 45 | 102 | 50 |
| Total | 1011 | 206 | 260 | 304 | 241 |
SACU provides central laboratories services and principal investigator roles to a number of clinical trials, both in UK and in Europe.
We collaborate with many institutions on clinical trials, which mainly focus on reducing antimicrobial prescribing or novel interventions to reduce prescribing.
We provide processing of primary samples, susceptibility testing, detection and characterisation of antimicrobial resistance mechanisms, data analysis and report writing.
The following clinical trials are currently being undertaken within SACU:
This study is in collaboration with Oxford University Vaccine Group and aims to evaluate the effect of immunisation against group B meningococcus on meningococcal carriage.
SACU and Health Protection within Public Health Wales collaborate with other centres around the UK by collecting and processing throat swabs from young adults.
SACU is processing and confirming presence of Neisseria meningitidis, the bacterium target of the menB vaccine and responsible for meningitis.
The study covers the years 2018-2021, with two collection periods in spring and autumn.
For more information: https://beontheteam.web.ox.ac.uk/
A study which will review the amount of mupirocin resistance in S. aureus from 200 patients across South East Wales following a change in practice for haemodialysis.
SACU has more than 15 years expertise in susceptibility testing using a variety of methodologies and has worked with several commercial partners to develop and validate both novel antimicrobials and a variety of susceptibility tests. Evaluation services provides by SACU varies from basic to bespoke.
SACU holds a large collection of clinically relevant Gram-negative and Gram-positive isolates (e.g. Enterobacteriales, Pseudomonas, Acinetobacter, Stenotrophomonas, Burkholderia, Staphylococci, Enterococci, Streptococci).
The collection includes isolates recovered from cohorts of patients and clinical scenarios (e.g. cystic fibrosis, COPD, UTI etc) and various resistance mechanisms (e.g. ESBL, ampC, carbapenemase, hGISA, VRE, etc…).
Antimicrobial susceptibility testing by broth microdilution (BMD), agar dilution, gradient strips and standardised EUCAST disc diffusion is offered. Expertise in more research based methods including synergy testing using time kill curves and chequerboard techniques as well as disinfectant testing using suspension tests is also available.
Resistance mechanism determination can be performed using inhibitor based phenotypic methods as well as by genotypic analysis by standard and real time Polymerase Chain Reaction (PCR).
Whole Genome Sequence (WGS) analysis is currently in development for use in the near future.
SACU can evaluate the following:
Please contact Dr Mandy Wootton by email or phone for more details:
E-mail: mandy.wootton@wales.nhs.uk
Tel: 029 20 743 610