Scottish One Health Antimicrobial Use and Antimicrobial Resistance in 2023 - Annual Report
Data and Resources
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Human antimicrobial resistance in Scotland: ...CSV
These data summarise the annual antimicrobial susceptibility testing (AST)...
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Human antimicrobial resistance in Scotland: ...CSV
These data summarise the antimicrobial susceptibility of...
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Human antimicrobial resistance in Scotland: ...CSV
These data summarise the annual total number of isolates and rate of cases...
Additional Info
| Field | Value |
|---|---|
| Author | Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland |
| Maintainer | ARHAI Scotland Data and Intelligence Team |
| Version | 1.0 |
| Last Updated | November 19, 2024, 09:32 (GMT) |
| Created | November 13, 2024, 10:22 (GMT) |
| Contact Address | ARHAI Scotland, NSS National Services Scotland, Delta House, 4th Floor, 50 West Nile Street, Glasgow, G1 2NP |
| Subject | Annual data on antimicrobial resistance in humans from NHSScotland |
| Frequency | Annual |
| Time frame of data and timeliness | Data are for 2019 to 2023. The latest iteration of data are 11 months in arrears at time of publication. |
| Coverage | NHS Scotland |
| Completeness | These data include annual data on antimicrobial resistance in humans, as reported in the Scottish One Health Antimicrobial Use and Antimicrobial Resistance in 2023 - Annual Report. Bacteraemia: All data for the reporting period have been included in the analysis. Bacteraemia data are the product of the Electronic Communication of Surveillance in Scotland (ECOSS). Participating laboratories routinely report all identifications of organisms, infection or microbiological intoxication, unless they are known to be of no clinical or public health importance. The collected data are used for; the identification of single cases of severe disease, outbreaks, and longer term trends in the incidence of laboratory reported infections enhanced surveillance, health protection, analytical and statistical use. Urinary tract infections caused by Escherichia coli: All available data within ECOSS have been included in the analysis. In 2022, it was identified that urine isolates from one NHS board had not been reported in ECOSS. Following investigation, isolates were reported from September 2022 onwards. Due to inconsistencies in data collection over time it has not been possible to report and compare incidence and AMR trends in urine isolates. Carbapenemase-producing organisms: ECOSS and the Scottish Microbiology Reference Laboratory (SMiRL), Glasgow. There were some carbapenemase-producing organism isolates where full antibiotic susceptibility testing was not carried out in 2023. |
| Accuracy | Bacteraemia: Data supplied by United Kingdom Accreditation Service (UKAS) accredited laboratories using standardised testing methodologies. Urinary tract infections caused by Escherichia coli: Data supplied by UKAS accredited laboratories using standardised testing methodologies. However, it should be noted that Public Health Scotland are undertaking an ECOSS quality improvement project (ECOSS Roll-out Implementation Programme (EDRIP)) which has highlighted some inconsistent mapping and reporting of urine sample results in ECOSS. EDRIP is currently paused due to the roll out of a new laboratory information management system. Due to these data inconsistencies, it is not currently possible to report and compare incidence over time, however we do not expect this to impact the national antimicrobial resistance. Carbapenemase-producing organisms: Data supplied by UKAS accredited laboratories using standardised testing methodologies. |
| Continuity of data | Throughout 2022, the majority of Scottish National Health Service (NHS) diagnostic laboratories, on a phased basis, changed from version 9.0 of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoint table to version 12.0. Breakpoints are generally lower in the EUCAST breakpoint table version 12.0. Exceptions to this are trimethoprim for both Enterobacterales and Staphylococcus aureus (S. aureus) and azithromycin for S. aureus only, where the breakpoint has increased. A reduction in a breakpoint will result in an increase in the number of isolates falling into the resistant category. Conversely, an increased breakpoint will result in a reduction in the numbers in the resistant category. This must be considered when interpreting results for this report. Prior to the 2022 SONAAR Annual Report, intermediate and resistant isolates were grouped and reported as one category: non-susceptible isolates. AMR results included in this report are percentage resistant as opposed to percentage non-susceptible, and therefore not comparable with SONAAR reports published in earlier years. Changes in healthcare activity and patient populations during the COVID-19 pandemic may have affected the epidemiology of infections included in this report and comparison of results should be interpreted with caution. |
| Concepts and definitions | Case definitions: Total numbers, incidence rates and antimicrobial susceptibility testing (AST) results for bacteraemia and bacteriuria were calculated using the following case definitions: A new case of bacteraemia is a patient from whom an organism has been isolated from the patient’s blood, and who has not previously had the same organism isolated from blood within a 14-day period (i.e. 14 days from date last positive sample obtained). The most complete then most resistant AST result during each episode is reported for each case. A new case of bacteriuria (referred to in this report as ‘episodes isolated from urine’) is a patient from whom an organism has been isolated from the patient’s urine, and who has not previously had the same organism isolated from urine within a 30-day period (i.e. 30 days from date last positive sample obtained). The most complete then most resistant AST result during each episode is reported for each case. Isolate(s) refers to the organism isolated from each case of bacteraemia or bacteriuria. With the exception of Escherichia coli bacteraemia and Staphylococcus aureus bacteraemia, all human bacteraemia data are based only on positive blood results extracted from ECOSS and are not validated cases. Escherichia coli bacteraemia and Staphylococcus aureus bacteraemia data use validated data collected as part of mandatory surveillance programme as detailed in the Protocol for National Enhanced Surveillance of Bacteraemia. Please note that bacteriuria (bacteria present in urine) is used as a proxy for urinary tract infection (UTI) and not all cases reported will be validated cases of UTI. As part of the NHS Pharmacy First Scotland service, community pharmacists have the ability to supply via patient group direction trimethoprim or nitrofurantoin for uncomplicated UTIs in females aged 16 to 65. This service has been available in all community pharmacies since August 2020 and is likely to have had an impact on the number of urine samples being referred to laboratories since females with uncomplicated UTIs can be treated by pharmacists without attending their General Practitioner. For carbapenamase-producing organisms, a case was considered as the first isolate of one specific organism per patient per calendar year. Where more than one organism was present in a sample, deduplication was carried out separately for each organism. Incidence rates were calculated as follows: Bacteraemia rate per 100,000 population = (Number of cases per year / mid-year Scottish population) x 100,000 |
| Disclosure | The PHS protocol on Statistical Disclosure is followed. |
| Revision statement | These data are not subject to planned major revisions. However, the data collection sources are live databases and may be subject to updates and amendments as further information is submitted. |
| Official statistics designation | Official Statistics |
| Relevance and key uses of the statistics | Making information publicly available. The report is intended to support planning, prioritisation and evaluation of initiatives to optimise antimicrobial use and to minimise antimicrobial resistance. |
| Format | CSV |
| Language | English |
| Links |