Retrospective analysis of antimicrobial susceptibility profiles of non- species from a tertiary hospital and reference laboratory, 2012-2023.

A total of 1,925 isolates were tested for antimicrobial susceptibility at the Mayo Clinic Microbiology laboratory (Rochester, Minnesota) from January 2012 to March 2023, with (35.6%) and (24.4%) identified as the predominant species. Species known to potentially carry diphtheria toxin were excluded. Common sources of isolation included skin and soft tissue (56.8%), bone and/or native joint synovial fluid (14.2%), urine (13.1%), sputum (6.1%), and blood (5.9%). For penicillin, susceptibility decreased from 47.5% (58 of 122) in 2012 to 20.6% (14 of 68) in 2023. Isolates also showed a decrease in susceptibility to erythromycin from 22.4% (26 of 116) in 2012 to 13.2% (9 of 68) in 2023. Susceptibility to trimethoprim-sulfamethoxazole averaged around 50% throughout the period. Notably, linezolid and vancomycin were universally effective against all species. The highest susceptibility rates among tested oral agents were to linezolid and doxycycline for non-. species. Daptomycin minimal inhibitory concentrations (MICs) of >256 µg/mL were observed for one isolate, one isolate, and for seven isolates, all from patients with prior daptomycin exposure. Daptomycin MICs of 2 µg/mL (nonsusceptible) were observed in one isolate recovered from a daptomycin-naïve patient and in six isolates, from both daptomycin-exposed and non-exposed patients. Significant variation in susceptibility profiles across different species underscores the importance of performing antimicrobial susceptibility testing to guide effective treatment. Moreover, multidrug resistance observed in poses substantial therapeutic challenges especially in patients requiring prolonged or chronic antibiotic suppression.