Emergence of High Levels of Extended-Spectrum-β-Lactamase-Producing Gram-Negative Bacilli in the Asia-Pacific Region: Data from the Study for Monitoring Antimicrobial Resistance Trends (SMART) Program, 2007

Hawser, Stephen; Bouchillon, S.; Hoban, Daryl J.; Badal, R.; Hsueh, Po-Ren; Paterson, David L.

doi:10.1128/aac.00426-09

Cited by 193 publications

(141 citation statements)

References 13 publications

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“…But perhaps most importantly, we found an even higher proportion of E. coli producers of ESBL in the isolates examined in here. This finding corresponds with previous studies not only in the Latin American region [15], but also from the Asia/ Pacific region (where India, China and Thailand reported the highest prevalence rates of ESBL-producing E. coli: 79.0%, 55.0% and 50.8% respectively [25]). In contrast, the results from this study differ from those conducted in other parts of the world, mainly North America and Europe; for example, in a study performed in Scotland on enterobacteriaceae isolates, only 7.5% of the isolates were phenotypically confirmed ESBL producers [26].…”

Section: Discussionsupporting

confidence: 80%

High Microbiological Spectrum Resistance Rates in urine isolates from Jalisco, Mexico. A retrospective study and literature review

Cerna

Macriz-Romero²,

Santoscoy-Gutierrez³

et al. 2015

Int Arch Med

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Background: Urinary tract infections (UTIs) are a major public health problem worldwide. In Latin America, most UTIs are treated without bacteriological identification. Our aim was to examine resistance rates to commonly prescribed antibiotics, focusing on cases from Jalisco, Mexico; and additionally to conduct a review of the literature to search for resistance patterns in other countries of Latin America. Methods: Results:We obtained 1.206 consecutive samples from outpatient and inpatient facilities, including adult and pediatric subjects. The most frequent isolate in all groups was ESBL-producing E. coli with high resistance rates for ampicillin, TMP-SMX, and ciprofloxacin. In the literature review we found 15 papers related to resistance rates of commonly prescribed antibiotics. Conclusions:The information summarized in this article supports the finding that resistance rates to commonly prescribed antimicrobial agents are increasing worldwide. As such, this study challenges the rationale behind empiric use of antibiotics, emphasizing the need, whenever possible, to perform urine cultures before initiating antimicrobial treatment.

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Section: Discussionsupporting

confidence: 80%

High Microbiological Spectrum Resistance Rates in urine isolates from Jalisco, Mexico. A retrospective study and literature review

Cerna

Macriz-Romero²,

Santoscoy-Gutierrez³

et al. 2015

Int Arch Med

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“…Some investigators continue to support the importance of knowing the ESBL status in an isolate to ensure proper therapy [5,6]. Especially in ESBL-endemic areas, where therapeutic options are very limited due to associated co-resistance in other classes of antimicrobial agents [7,8]. Moreover, in a survey on 144 infectious disease specialists, most respondents reported that they would not treat Enterobacteriaceae infections based on the current breakpoints alone without testing for ESBL [9].…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial resistance to cefotaxime and ertapenem in Enterobacteriaceae: the effects of altering clinical breakpoints

Liu

Shi

Tung

et al. 2014

J Infect Dev Ctries

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Introduction: The Clinical and Laboratory Standards Institute (CLSI) updated its antimicrobial susceptibility testing interpretation criteria for Enterobacteriaceae. This study assessed the effects of clinical breakpoint changes in the CLSI 2009 to 2012 guidelines on antibiotic susceptibility testing reports. Methodology: In total, 2,076 non-duplicate clinical isolates of Enterobacteriaceae were analyzed. The disk diffusion method was used for susceptibility testing. The CLSI 2009-12 clinical breakpoints were applied to determine susceptibility of cefotaxime and ertapenem. Combined-disk testing was used for phenotypic confirmation of extended-spectrum beta-lactamase (ESBL) production. Results: In total, Enterobacteriaceae resistance rates to cefotaxime increased from 13.1% using the CLSI 2009 guidelines to 23.6% with the CLSI 2010-12 guidelines, and the resistance rates to ertapenem were 0.4%, 1.0% and 0.8% with CLSI 2009, 2011 and 2012, respectively. Based on the 2010-12 CLSI criteria, all ESBL-producing Escherichia coli and Klebsiella pneumoniae were resistant to cefotaxime. Marked differences in susceptibility to ertapenem between the 2009 CLSI criteria and 2012-12 CLSI criteria were noted in ESBL-producing K. pneumoniae. Conclusions: Breakpoints changes in the updated CLSI guidelines resulted in higher resistance rates to cefotaxime and ertapenem. In addition, the effects were different in individual Enterobacteriaceae species. As a result, clinicians may opt to use alternative antimicrobial agents. Upon implementation of the newer CLSI guidelines, laboratories should be aware of the possible consequences and closely monitor the effects.

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“…Reports from SMART in the Asia-Pacific region showed certain countries to be associated with the highest levels of antimicrobial resistance among these pathogens globally. Extended-spectrum b-lactamase (ESBL) production by strains of Escherichia coli and Klebsiella pneumoniae in countries such as Thailand, China, and India have been documented to be 53.0% and 23.1%, 65.% and 31.9% and 67.0% and 55.0%, respectively [9][10][11][12].…”

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confidence: 99%

Antimicrobial Susceptibility of Gram-Negative Pathogens Isolated from Patients with Complicated Intra-Abdominal Infections in South African Hospitals (SMART Study 2004–2009): Impact of the New Carbapenem Breakpoints

Brink

Botha²,

Poswa³

et al. 2012

Surgical Infections

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Background: The Study for Monitoring Antimicrobial Resistance Trends (SMART) follows trends in resistance among aerobic and facultative anaerobic gram-negative bacilli (GNB) isolated from complicated intra-abdominal infections (cIAIs) in patients around the world. Results: Enterobacteriaceae comprised 83.7% of the isolates. Escherichia coli was the species isolated most commonly (46.4%), and 7.6% of these were extended-spectrum b-lactamase (ESBL)-positive. The highest ESBL rate was documented for Klebsiella pneumoniae (41.2%). Overall, ertapenem was the antibiotic most active against susceptible species for which it has breakpoints (94.6%) followed by amikacin (91.9%), piperacillin-tazobactam (89.3%), and imipenem-cilastatin (87.1%), whereas rates of resistance to ceftriaxone, cefotaxime, ciprofloxacin, and levofloxacin were documented to be 29.7%, 28.7%, 22.5%, and 21.1%, respectively. Multi-drug resistance (MDR), defined as resistance to three or more antibiotic classes, was significantly more common in K. pneumoniae (27.9%) than in E. coli (4.9%; p < 0.0001) or Proteus mirabilis (4.1%; p < 0.05). Applying the new CLSI breakpoints for carbapenems, susceptibility to ertapenem was reduced significantly in ESBL-positive E. coli compared with ESBL-negative isolates (91% vs. 98%; p < 0.05), but this did not apply to imipenem-cilastatin (95% vs. 99%; p = 0.0928). A large disparity between imipenem-cilastatin and ertapenem susceptibility in P. mirabilis and Morganella morganii was documented (24% vs. 96% and 15% vs. 92%, respectively), as most isolates of these two species had imipenem-cilastatin minimum inhibitory concentrations in the 2-4 mcg/mL range, which is no longer regarded as susceptible. Conclusions: This study documented substantial resistance to standard antimicrobial therapy among GNB commonly isolated from cIAIs in South Africa. With the application of the new CLSI carbapenem breakpoints, discrepancies were noted between ertapenem and imipenem-cilastatin with regard to the changes in their individual susceptibilities. Longitudinal surveillance of susceptibility patterns is useful to guide recommendations for empiric antibiotic use in cIAIs.

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Emergence of High Levels of Extended-Spectrum-β-Lactamase-Producing Gram-Negative Bacilli in the Asia-Pacific Region: Data from the Study for Monitoring Antimicrobial Resistance Trends (SMART) Program, 2007

Cited by 193 publications

References 13 publications

High Microbiological Spectrum Resistance Rates in urine isolates from Jalisco, Mexico. A retrospective study and literature review

High Microbiological Spectrum Resistance Rates in urine isolates from Jalisco, Mexico. A retrospective study and literature review

Antimicrobial resistance to cefotaxime and ertapenem in Enterobacteriaceae: the effects of altering clinical breakpoints

Antimicrobial Susceptibility of Gram-Negative Pathogens Isolated from Patients with Complicated Intra-Abdominal Infections in South African Hospitals (SMART Study 2004–2009): Impact of the New Carbapenem Breakpoints

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