Antimicrobial susceptibility of Gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal and urinary tract infections in Asia-Pacific countries: SMART 2013-2015

被引:56
|
作者
Karlowsky, James A. [1 ]
Hoban, Daryl J. [1 ,2 ]
Hackel, Meredith A. [2 ]
Lob, Sibylle H. [2 ]
Sahm, Daniel F. [2 ]
机构
[1] Univ Manitoba, Dept Med Microbiol, Coll Med, 745 Bannatyne Ave, Winnipeg, MB R3E 0J9, Canada
[2] Int Hlth Management Associates Inc, 2122 Palmer Dr, Schaumburg, IL 60173 USA
关键词
SMART; surveillance; imipenem; ertapenem; Asia-Pacific; ESKAPE pathogens; IN-VITRO SUSCEPTIBILITIES; DISEASES SOCIETY; RESISTANCE; TRENDS; REGION; ENTEROBACTERIACEAE; CARBAPENEMASES; EPIDEMIOLOGY; PROFILES;
D O I
10.1099/jmm.0.000421
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Gram-negative ESKAPE pathogens (Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) are responsible for increases in antimicrobial-resistant infections worldwide. We determined in vitro susceptibilities to eight parenteral antimicrobial agents using Clinical and Laboratory Standards Institute broth microdilution methodology for Gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal infections (IAIs) (n = 3052) and urinary tract infections (UTIs) (n = 1088) in 11 Asia-Pacific countries/regions from 2013 to 2015. Amikacin (98.3, 96.4 %), imipenem (97.1, 95.5 %) and ertapenem (95.3, 93.2 %) demonstrated the highest rates of susceptibility for isolates of K. pneumoniae from IAI and UTI, respectively, whereas susceptibility to advanced-generation cephalosporins was < 4 and <71 %, respectively. K. pneumoniae with an extended-spectrum beta-lactamase-positive phenotype were more common in UTI (27.1 %) than IAI (16.2 %). Imipenem and amikacin were the most active agents against extended-spectrum beta-lactamase-positive K. pneumoniae from IAI (95.1, 91.8 %) and UTI (94.9, 92.3 %), respectively, whereas < 54% were susceptible to piperacillin-tazobactam. Against Enterobacter spp. and P. aeruginosa, amikacin demonstrated the highest rates of susceptibility for isolates from IAI (99.7, 95.5 %) and UTI (90.9, 91.5 %), respectively. K. pneumoniae, Enterobacter spp. and P. aeruginosa from urine demonstrated lower susceptibility to levofloxacin (74.1, 81.8 and 73.8 %) than from IAI (87.6, 91.8 and 85.4 %). For A. baumannii, rates of susceptibility to all agents tested were <43 %. We conclude that the studied Gram-negative ESKAPE pathogens demonstrated reduced susceptibility to commonly prescribed advanced-generation cephalosporins, piperacillin-tazobactam and levofloxacin, while amikacin and carbapenems were the most active. Ongoing surveillance to monitor evolving resistance trends and the development of novel antimicrobial agents with potent activity against Gram-negative ESKAPE pathogens are mandatory.
引用
收藏
页码:61 / 69
页数:9
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