Impact of revised CLSI breakpoints for susceptibility to third-generation cephalosporins and carbapenems among Enterobacteriaceae isolates in the Asia-Pacific region: results from the Study for Monitoring Antimicrobial Resistance Trends (SMART), 2002–2010

Huang, Chih‐Wei; Chen, Yao Shen; Toh, Han Siong; Lee, Yu Lin; Liu, Yuag Meng; Ho, Cheng-Mao; Lu, Po Liang; Liu, Chun Eng; Chen, Yen Hsu; Wang, Jen Hsien; Tang, Hung Jen; Yu, Kwok Woon; Liu, Yung Ching; Chuang, Yin Ching; Xu, Yingchun; Ni, Yizhao; Ko, Wen Chien; Hsueh, Po-Ren

doi:10.1016/s0924-8579(12)70003-1

Cited by 35 publications

(28 citation statements)

References 26 publications

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“…Previous studies showed that the rate of ertapenem resistance in Enterobacteriaceae isolates worldwide was low based on the CLSI 2011 criteria [17]. More recently, Huang et al reported that the resistance rate may be higher in some Enterobacteriaceae species and certain countries [18]. In our study, only 77.4% of ESBL-positive K. pneumoniae isolates were susceptible to ertapenem according to the CLSI 2011 criteria, while ertapenem was active in more than 99% of E. coli isolates.…”

Section: Discussioncontrasting

confidence: 43%

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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Section: Discussioncontrasting

confidence: 43%

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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“…In E. coli, the sensitivity rate of fluoroquinolones antimicrobial drugs was secondary only to carbapenems in CIAIs, which is consistent with recommended antimicrobial agents for CIAIs in ACT-IAI guideline; while the sensitivity of cephalosporin class recommended by IDSA guideline is low in this study to CIAIs; maybe the rate of EBLS-producing E. coli in China is higher than that in the United States. 9 It suggests that antimicrobial agents recommended by ACT-IAI guidelines may be more applicable than by the IDSA guidelines when treating IAIs with E. coli infection. In addition, fluoroquinolone recommended by IDSA can be used for CIAIs treatment, but this study suggests that the CIAI bacterial sensitivity rate of fluoroquinolone should be lower than 70% in CIAIs, while resistance was greater in NIAIs.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological study of community- and hospital-acquired intraabdominal infections

Zhang

Huang

2015

Chinese Journal of Traumatology

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“…11 In Asia, China and Thailand were reported to have the highest prevalence of ESBL producers (33.7% and 40.7%, respectively). 96 Carbapenem resistance has become the most important epidemiologic and therapeutic challenge in K. pneumoniae. 82 There are mainly 3 classes of carbapenemases involved including KPC (Class A), OXA-48 (Class D) and NDM (Class B) for which different epidemiological reservoirs exist.…”

Section: Klebsiella Pneumoniaementioning

confidence: 99%

Epidemiology of antimicrobial resistance in bloodstream infections

2016

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Antimicrobial resistance in bacterial pathogens is a worldwide challenge leading high morbidity and mortality in clinical settings. Multidrug resistant patterns in gram-positive and -negative bacteria have resulted in difficult-to-treat or even untreatable infections with conventional antimicrobials. Since the early identification of causative microorganisms and their antimicrobial susceptibility patterns in patients with bacteremia and other serious infections is lacking in many healthcare institutions, broad spectrum antibiotics are liberally and mostly unnecessarily used. Such practice has, in turn, caused dramatic increases in emerging resistance and when coupled with poor practice of infection control, resistant bacteria can easily be disseminated to the other patients and the environment. Thus, availability of updated epidemiological data on antimicrobial resistance in frequently encountered bacterial pathogens will be useful not only for deciding on empirical treatment strategies, but also devising an effective antimicrobial stewardship program in hospitals.

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Impact of revised CLSI breakpoints for susceptibility to third-generation cephalosporins and carbapenems among Enterobacteriaceae isolates in the Asia-Pacific region: results from the Study for Monitoring Antimicrobial Resistance Trends (SMART), 2002–2010

Cited by 35 publications

References 26 publications

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

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

Epidemiological study of community- and hospital-acquired intraabdominal infections

Epidemiology of antimicrobial resistance in bloodstream infections

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