Bloodstream Infection among Adults in Phnom Penh, Cambodia: Key Pathogens and Resistance Patterns

被引:46
作者
Vlieghe, Erika R. [1 ]
Phe, Thong [2 ]
De Smet, Birgit [1 ]
Veng, Heng Chhun [2 ]
Kham, Chun [2 ]
Lim, Kruy [2 ]
Koole, Olivier [1 ]
Lynen, Lut [1 ]
Peetermans, Willy E. [3 ]
Jacobs, Jan A. [1 ]
机构
[1] Inst Trop Med, Dept Clin Sci, B-2000 Antwerp, Belgium
[2] Sihanouk Hosp Ctr HOPE, Phnom Penh, Cambodia
[3] Univ Hosp, Dept Internal Med, Louvain, Belgium
来源
PLOS ONE | 2013年 / 8卷 / 03期
关键词
ANTIMICROBIAL RESISTANCE; ACQUIRED BACTEREMIA; BETA-LACTAMASES; HEALTH-CARE; AUREUS; SUSCEPTIBILITY; AZITHROMYCIN; PREVALENCE; DISEASE; ASIA;
D O I
10.1371/journal.pone.0059775
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Bloodstream infections (BSI) cause important morbidity and mortality worldwide. In Cambodia, no surveillance data on BSI are available so far. Methods: From all adults presenting with SIRS at Sihanouk Hospital Centre of HOPE (July 2007-December 2010), 20 ml blood was cultured. Isolates were identified using standard microbiological techniques; antibiotic susceptibilities were assessed using disk diffusion and MicroScan (R), with additional E-test, D-test and double disk test where applicable, according to CLSI guidelines. Results: A total of 5714 samples from 4833 adult patients yielded 501 clinically significant organisms (8.8%) of which 445 available for further analysis. The patients' median age was 45 years (range 15-99 y), 52.7% were women. HIV-infection and diabetes were present in 15.6% and 8.8% of patients respectively. The overall mortality was 22.5%. Key pathogens included Escherichia coli (n = 132; 29.7%), Salmonella spp. (n = 64; 14.4%), Burkholderia pseudomallei (n = 56; 12.6%) and Staphylococcus aureus (n = 53; 11.9%). Methicillin resistance was seen in 10/46 (21.7%) S. aureus; 4 of them were co-resistant to erythromycin, clindamycin, moxifloxacin and sulphamethoxazole-trimethoprim (SMX-TMP). We noted combined resistance to amoxicillin, SMX-TMP and ciprofloxacin in 81 E. coli isolates (62.3%); 62 isolates (47.7%) were confirmed as producers of extended spectrum beta-lactamase. Salmonella isolates displayed high rates of multidrug resistance (71.2%) with high rates of decreased ciprofloxacin susceptibility (90.0%) in Salmonella Typhi while carbapenem resistance was observed in 5.0% of 20 Acinetobacter sp. isolates. Conclusions: BSI in Cambodian adults is mainly caused by difficult-to-treat pathogens. These data urge for microbiological capacity building, nationwide surveillance and solid interventions to contain antibiotic resistance.
引用
收藏
页数:9
相关论文
共 37 条
  • [1] Risk and causes of paediatric hospital-acquired bacteraemia in Kilifi District Hospital, Kenya: a prospective cohort study
    Aiken, Alexander M.
    Mturi, Neema
    Njuguna, Patricia
    Mohammed, Shebe
    Berkley, James A.
    Mwangi, Isaiah
    Mwarumba, Salim
    Kitsao, Barnes S.
    Lowe, Brett S.
    Morpeth, Susan C.
    Hall, Andrew J.
    Khandawalla, Iqbal
    Scott, J. Anthony G.
    [J]. LANCET, 2011, 378 (9808) : 2021 - 2027
  • [2] [Anonymous], 2012, PERFORMANCE STANDARD
  • [3] Surviving sepsis in low-income and middle-income countries: new directions for care and research
    Becker, Joseph U.
    Theodosis, Christian
    Jacob, Shevin T.
    Wira, Charles R.
    Groce, Nora Ellen
    [J]. LANCET INFECTIOUS DISEASES, 2009, 9 (09) : 577 - 582
  • [4] Chareonkul Chanin, 2002, Southeast Asian Journal of Tropical Medicine and Public Health, V33, P418
  • [5] Antimicrobial susceptibility profiles of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in the Asia-Pacific region according to currently established susceptibility interpretive criteria
    Chen, Yen-Hsu
    Hsueh, Po-Ren
    Badal, Robert E.
    Hawser, Stephen P.
    Hoban, Daryl J.
    Bouchillon, Samuel K.
    Ni, Yuxing
    Paterson, David L.
    [J]. JOURNAL OF INFECTION, 2011, 62 (04) : 280 - 291
  • [6] Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Associated with Pediatric Infection in Cambodia
    Chheng, Kheng
    Tarquinio, Sarah
    Wuthiekanun, Vanaporn
    Sin, Lina
    Thaipadungpanit, Janjira
    Amornchai, Premjit
    Chanpheaktra, Ngoun
    Tumapa, Sarinna
    Putchhat, Hor
    Day, Nicholas P. J.
    Peacock, Sharon J.
    [J]. PLOS ONE, 2009, 4 (08):
  • [7] Salmonella enterica serotype choleraesuis:: Epidemiology, pathogenesis, clinical disease, and treatment
    Chiu, CH
    Su, LH
    Chu, C
    [J]. CLINICAL MICROBIOLOGY REVIEWS, 2004, 17 (02) : 311 - +
  • [8] European recommendations for antimicrobial resistance surveillance
    Cornaglia, G
    Hryniewicz, W
    Jarlier, V
    Kahlmeter, G
    Mittermayer, H
    Stratchounski, L
    Baquero, F
    [J]. CLINICAL MICROBIOLOGY AND INFECTION, 2004, 10 (04) : 349 - 383
  • [9] Grimont P A, 2007, Antigenic formulae of the Salmonella serovars, V9th
  • [10] Social and cultural dimensions of hygiene in Cambodian health care facilities
    Hancart-Petitet, Pascale
    Dumas, Celine
    Faurand-Tournaire, Anne-Laure
    Desclaux, Alice
    Vong, Sirenda
    [J]. BMC PUBLIC HEALTH, 2011, 11