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)

Shio Shin Jean, Po Ren Hsueh, Tony Korman, Justin Ellem, Narelle George, Geoffrey Coombs, Thomas Ling, Owen Tsang, V. Balaji, Hiroshige Mikamo, Shinya Kusachi, Tetsu Mizutani, Min Ja Kim, In Gyu Bae, Nurulhuda Binti Umur, Datin Ganeswrie Rajasekaram, Susan Taylor, Sally Roberts, Koen van der Werff, Dragana DrinkovicEvelina Lagamayo, Myrna Mendoza, Thean Yen Tan, Prabha Krishnan, Ellie Wang, Po Liang Lu, Chun Eng Liu, Kenneth Yin Ching Chuang, Kwok Woon Yu, Yao Shen Chen, Min Chi Lu, Siripen Panthuwong, Pattarachai Kiratisin, Nguyen Tran My Phoung, Doan Mai Phuong, Nguyen Thi Quynh Ngoc, Tran Thi Thanh Nga

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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.

Original languageEnglish
Pages (from-to)166-171
Number of pages6
JournalJournal of Antimicrobial Chemotherapy
Volume72
Issue number1
DOIs
Publication statusPublished - 2017

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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    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., ... Nga, T. T. T. (2017). 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). Journal of Antimicrobial Chemotherapy, 72(1), 166-171. https://doi.org/10.1093/jac/dkw398