Nationwide Surveillance and Molecular Characterization of Critically Drug-Resistant Gram-Negative Bacteria: Results of the Research University Network Thailand Study
| Autor: | Romanee Chaiwarith, Thitiya Yungyuen, Orawan Tulyaprawat, Prawat Chantharit, Dennapa Saeloh, Rongpong Plongla, Sarunyou Chusri, Umaporn Yordpratum, Tanittha Chatsuwan, Surat Wannalerdsakun, Iyarit Thaipisuttikul, Worada Samosornsuk, Supayang Piyawan Voravuthikunchai, Pattarachai Kiratisin, Sakawrat Kanthawong, Porpon Rotjanapan, Nuntra Suwantarat |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Bacilli
Universities Klebsiella pneumoniae Drug resistance Microbial Sensitivity Tests medicine.disease_cause beta-Lactamases Microbiology Epidemiology and Surveillance Antibiotic resistance medicine Escherichia coli Humans Pharmacology (medical) Pharmacology drug resistance biology Pseudomonas aeruginosa biology.organism_classification Thailand Acinetobacter baumannii Anti-Bacterial Agents Multiple drug resistance Infectious Diseases Pharmaceutical Preparations Gram-negative bacteria surveillance bla gene |
| Zdroj: | Antimicrobial Agents and Chemotherapy |
| ISSN: | 1098-6596 0066-4804 |
| Popis: | A large-scale surveillance is an important measure to monitor the regional spread of antimicrobial resistance. We prospectively studied the prevalence and molecular characteristics of clinically important Gram-negative bacilli, including Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii complex (ABC), and Pseudomonas aeruginosa, from blood, respiratory tract, urine, and sterile sites at 47 hospitals across Thailand. Among 187,619 isolates, 93,810 isolates (50.0%) were critically drug resistant, of which 12,915 isolates (13.8%) were randomly selected for molecular characterization. E. coli was most commonly isolated from all specimens, except the respiratory tract, in which ABC was predominant. Prevalence of extended-spectrum cephalosporin resistance (ESCR) was higher in E. coli (42.5%) than K. pneumoniae (32.0%), but carbapenem-resistant (CR)-K. pneumoniae (17.2%) was 4.5-fold higher than CR-E. coli (3.8%). The majority of ESCR/CR-E. coli and K. pneumoniae isolates carried blaCTX-M (64.6% to 82.1%). blaNDM and blaOXA-48-like were the most prevalent carbapenemase genes in CR-E. coli/CR-K. pneumoniae (74.9%/52.9% and 22.4%/54.1%, respectively). In addition, 12.9%/23.0% of CR-E. coli/CR-K. pneumoniae cocarried blaNDM and blaOXA-48-like. Among ABC isolates, 41.9% were extensively drug resistant (XDR) and 35.7% were multidrug resistant (MDR), while P. aeruginosa showed XDR/MDR at 6.3%/16.5%. A. baumannii was the most common species among ABC isolates. The major carbapenemase gene in MDR-A. baumannii/XDR-A. baumannii was blaOXA-23-like (85.8%/93.0%), which had much higher rates than other ABC species. blaIMP, blaVIM, blaOXA-40-like, and blaOXA-58-like were also detected in ABC at lower rates. The most common carbapenemase gene in MDR/XDR-P. aeruginosa was blaIMP (29.0%/30.6%), followed by blaVIM (9.5%/25.3%). The findings reiterate an alarming situation of drug resistance that requires serious control measures. |
| Databáze: | OpenAIRE |
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