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Targeted Surveillance (SACU 2021)

All Wales 3GC targeted surveillance study

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)

2020 surveillance:

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

Clinical Trials

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:

MenB Study

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:

Review of Mupirocin resistance in S. aureus

 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.

Commercial and Research Studies 

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:

  1. Gradient strips and discs for new agents. 
  2. Novel susceptibility testing methods.    
    • New techniques.
    • Rapid techniques.
    • Commercial susceptibility testing instruments.
  3. Novel antimicrobials.
    • Basic antibacterial evaluation of unknown compounds.
    • Phase I trials.
  4. Resistance mechanism determination.
    • Phenotypic methods.
    • Genotypic methods
    • Commercial instruments.

 Please contact Dr Mandy Wootton by email or phone for more details:


Tel: 029 20 743 610