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.

doi:10.1093/jac/dkw398

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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.

Date

2017

Type

Journal Article

Metadata

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Citation

Jean, S. and Hsueh, P. and Korman, T. and Ellem, J. and George, N. and Coombs, G. and Ling, T. et al. 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). The Journal of antimicrobial chemotherapy. 72 (1): pp. 166-171.

Source Title

The Journal of antimicrobial chemotherapy

DOI

10.1093/jac/dkw398

ISSN

0305-7453

School

School of Pharmacy and Biomedical Sciences

URI

http://hdl.handle.net/20.500.11937/67585

Collection

Curtin Research Publications

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 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.