TY - JOUR
T1 - 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
T2 - Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART)
AU - SMART Asia-Pacific Group
AU - Jean, Shio Shin
AU - Hsueh, Po Ren
AU - Korman, Tony
AU - Ellem, Justin
AU - George, Narelle
AU - Coombs, Geoffrey
AU - Ling, Thomas
AU - Tsang, Owen
AU - Balaji, V.
AU - Mikamo, Hiroshige
AU - Kusachi, Shinya
AU - Mizutani, Tetsu
AU - Kim, Min Ja
AU - Bae, In Gyu
AU - Umur, Nurulhuda Binti
AU - Rajasekaram, Datin Ganeswrie
AU - Taylor, Susan
AU - Roberts, Sally
AU - van der Werff, Koen
AU - Drinkovic, Dragana
AU - Lagamayo, Evelina
AU - Mendoza, Myrna
AU - Tan, Thean Yen
AU - Krishnan, Prabha
AU - Wang, Ellie
AU - Lu, Po Liang
AU - Liu, Chun Eng
AU - Chuang, Kenneth Yin Ching
AU - Yu, Kwok Woon
AU - Chen, Yao Shen
AU - Lu, Min Chi
AU - Panthuwong, Siripen
AU - Kiratisin, Pattarachai
AU - Phoung, Nguyen Tran My
AU - Phuong, Doan Mai
AU - Van, Nguyen Thi
AU - Nga, Tran Thi Thanh
N1 - Publisher Copyright:
© The Author 2016.
PY - 2017/1
Y1 - 2017/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85014571133&partnerID=8YFLogxK
U2 - 10.1093/jac/dkw398
DO - 10.1093/jac/dkw398
M3 - Article
C2 - 27703058
AN - SCOPUS:85014571133
SN - 0305-7453
VL - 72
SP - 166
EP - 171
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 1
ER -
