Distribution of ESBLs, AmpC β-lactamases and carbapenemases among Enterobacteriaceae isolates causing intra-abdominal and urinary tract infections in the Asia-Pacific region during 2008-14: Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART)
- Authors
- Jean, S.-S.; Hsueh, P.-R.; Korman, T.; Ellem, J.; George, N.; Coombs, G.; Ling, T.; Tsang, O.; Balaji, V.; Mikamo, H.; Kusachi, S.; Mizutani, T.; Kim, M.-J.; Bae, I.-G.; Umur, N.B.; Rajasekaram, D.G.; Taylor, S.; Roberts, S.; van, der Werff K.; Drinkovic, D.; Lagamayo, E.; Mendoza, M.; Tan, T.Y.; Krishnan, P.; Wang, E.; Lu, P.-L.; Liu, C.-E.; Chuang, K.Y.-C.; Yu, K.-W.; Chen, Y.-S.; Lu, M.-C.; Panthuwong, S.; Kiratisin, P.; Phoung, N.T.M.; Phuong, D.M.; Van, N.T.; Nga, T.T.T.; SMART Asia-Pacific Group
- Issue Date
- 2017
- Publisher
- Oxford University Press
- Citation
- Journal of Antimicrobial Chemotherapy, v.72, no.1, pp.166 - 171
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Antimicrobial Chemotherapy
- Volume
- 72
- Number
- 1
- Start Page
- 166
- End Page
- 171
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/86117
- DOI
- 10.1093/jac/dkw398
- ISSN
- 0305-7453
- Abstract
- Objectives: To investigate the antimicrobial resistance and assess the molecular characteristics of β-lactamases (ESBLs, AmpC β-lactamases and carbapenemases) among Enterobacteriaceae isolates that caused intraabdominal infections (IAIs) in patients hospitalized in the Asia-Pacific region during 2008-14. Methods: Multiplex PCR was used to detect the specific types of β-lactamase in 2893 isolates with MICs of ertapenem.0.5 mg/L. In-hospital acquisition times for most isolates were also delineated. Results: Among 2728 (94.3%) isolates proven with β-lactamase production, the rates of non-susceptibility to imipenem were low (average=7.9%) among IAI Enterobacteriaceae isolates from all Asia-Pacific countries except Vietnam (17.7%) and the Philippines (10.2%). A stepwise and significant increase in annual rates of carbapenemase production among these isolates was noted. CTX-M-15 and CTX-M-14 were the dominant ESBL variants in most IAI Enterobacteriaceae species. The most abundant AmpC β-lactamase variants were blaCMY-2 among isolates of Escherichia coli and blaDHA-1 among isolates of Klebsiella pneumoniae. In addition, the IAI Enterobacteriaceae isolates harbouring a blaCMY-2 or blaDHA-1 allele were associated with high communityacquired rates (38.0% and 42.6%, respectively). AmpC ACT and MIR variants were mostly detected in Enterobacter species. The blaNDM-1,4,5,7-harbouring isolates of E. coli, K. pneumoniae and Enterobacter cloacae were most commonly identified among IAI isolates from Vietnam and the Philippines. Also of note, blaOXA-48- harbouring IAI Enterobacteriaceae isolates were detected exclusively in Vietnam. Conclusions: The high resistance burden in Vietnam and the Philippines warrants aggressive control policies to combat the worsening trend in antimicrobial resistance among Enterobacteriaceae species causing IAIs. © The Author 2016.
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