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)

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 intra-abdominal infections (IAIs) in patients hospitalized in the Asia-Pacific region during 20...

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Main Authors: Jean, S., Hsueh, P., Korman, T., Ellem, J., George, N., Coombs, Geoffrey, Ling, T., Tsang, O., Balaji, V., Mikamo, H., Kusachi, S., Mizutani, T., Kim, M., Bae, I., Umur, N., Rajasekaram, D., Taylor, S., Roberts, S., van der Werff, K., Drinkovic, D., Lagamayo, E., Mendoza, M., Tan, T., Krishnan, P., Wang, E., Lu, P., Liu, C., Chuang, K., Yu, K., Chen, Y., Lu, M., Panthuwong, S., Kiratisin, P., Phoung, N., Phuong, D., Van, N., Nga, T.
Format: Journal Article
Published: Oxford University Press 2017
Online Access:http://hdl.handle.net/20.500.11937/67585
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author Jean, S.
Hsueh, P.
Korman, T.
Ellem, J.
George, N.
Coombs, Geoffrey
Ling, T.
Tsang, O.
Balaji, V.
Mikamo, H.
Kusachi, S.
Mizutani, T.
Kim, M.
Bae, I.
Umur, N.
Rajasekaram, D.
Taylor, S.
Roberts, S.
van der Werff, K.
Drinkovic, D.
Lagamayo, E.
Mendoza, M.
Tan, T.
Krishnan, P.
Wang, E.
Lu, P.
Liu, C.
Chuang, K.
Yu, K.
Chen, Y.
Lu, M.
Panthuwong, S.
Kiratisin, P.
Phoung, N.
Phuong, D.
Van, N.
Nga, T.
author_facet Jean, S.
Hsueh, P.
Korman, T.
Ellem, J.
George, N.
Coombs, Geoffrey
Ling, T.
Tsang, O.
Balaji, V.
Mikamo, H.
Kusachi, S.
Mizutani, T.
Kim, M.
Bae, I.
Umur, N.
Rajasekaram, D.
Taylor, S.
Roberts, S.
van der Werff, K.
Drinkovic, D.
Lagamayo, E.
Mendoza, M.
Tan, T.
Krishnan, P.
Wang, E.
Lu, P.
Liu, C.
Chuang, K.
Yu, K.
Chen, Y.
Lu, M.
Panthuwong, S.
Kiratisin, P.
Phoung, N.
Phuong, D.
Van, N.
Nga, T.
author_sort Jean, S.
building Curtin Institutional Repository
collection Online Access
description 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 intra-abdominal 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 community-acquired 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 cloacaewere 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.
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institution Curtin University Malaysia
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last_indexed 2025-11-14T10:34:18Z
publishDate 2017
publisher Oxford University Press
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spelling curtin-20.500.11937-675852018-09-26T00:46:18Z 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) Jean, S. Hsueh, P. Korman, T. Ellem, J. George, N. Coombs, Geoffrey Ling, T. Tsang, O. Balaji, V. Mikamo, H. Kusachi, S. Mizutani, T. Kim, M. Bae, I. Umur, N. Rajasekaram, D. Taylor, S. Roberts, S. van der Werff, K. Drinkovic, D. Lagamayo, E. Mendoza, M. Tan, T. Krishnan, P. Wang, E. Lu, P. Liu, C. Chuang, K. Yu, K. Chen, Y. Lu, M. Panthuwong, S. Kiratisin, P. Phoung, N. Phuong, D. Van, N. Nga, T. 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 intra-abdominal 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 community-acquired 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 cloacaewere 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. 2017 Journal Article http://hdl.handle.net/20.500.11937/67585 10.1093/jac/dkw398 Oxford University Press restricted
spellingShingle Jean, S.
Hsueh, P.
Korman, T.
Ellem, J.
George, N.
Coombs, Geoffrey
Ling, T.
Tsang, O.
Balaji, V.
Mikamo, H.
Kusachi, S.
Mizutani, T.
Kim, M.
Bae, I.
Umur, N.
Rajasekaram, D.
Taylor, S.
Roberts, S.
van der Werff, K.
Drinkovic, D.
Lagamayo, E.
Mendoza, M.
Tan, T.
Krishnan, P.
Wang, E.
Lu, P.
Liu, C.
Chuang, K.
Yu, K.
Chen, Y.
Lu, M.
Panthuwong, S.
Kiratisin, P.
Phoung, N.
Phuong, D.
Van, N.
Nga, T.
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)
title 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)
title_full 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)
title_fullStr 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)
title_full_unstemmed 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)
title_short 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)
title_sort 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)
url http://hdl.handle.net/20.500.11937/67585