TY - JOUR
T1 - Nationwide surveillance and molecular characterization of critically drug-resistant gram-negative bacteria
T2 - Results of the research university network Thailand study
AU - Research University Network Thailand Study Group
AU - Yungyuen, Thitiya
AU - Chatsuwan, Tanittha
AU - Plongla, Rongpong
AU - Kanthawong, Sakawrat
AU - Yordpratum, Umaporn
AU - Voravuthikunchai, Supayang P.
AU - Chusri, Sarunyou
AU - Saeloh, Dennapa
AU - Samosornsuk, Worada
AU - Suwantarat, Nuntra
AU - Chaiwarith, Romanee
AU - Wannalerdsakun, Surat
AU - Rotjanapan, Porpon
AU - Chantharit, Prawat
AU - Tulyaprawat, Orawan
AU - Thaipisuttikul, Iyarit
AU - Kiratisin, Pattarachai
AU - Sornwiboonsak, Pakpiengpen
AU - Thongnark, Nanthawadee
AU - Thepchai, Niporn
AU - Ponglorpisit, Pattraporn
AU - Rungnobhakhun, Pimpa
AU - Onraj, Wijittraporn
AU - Pitakwong, Piyanat
AU - Nitchot, Watchanarat
AU - Saensud, Jareerat
AU - Phimsen, Jintana
AU - Jaifoo, Theerasak
AU - Srisurat, Nuttiya
AU - Kamlangharn, Krittika
AU - Punakabutra, Napawan
AU - Lukin, Sirirat
AU - Wongsawat, Nalinwan
AU - Nantasan, Supat
AU - Saengsawang, Kanokwan
AU - Tangkosakul, Thitirat
AU - Boonrod, Parichat
AU - Chuenchom, Nattagarn
AU - Wongchai, Thanee
AU - Khamnoi, Phadungkiat
AU - Nuket, Khanuengnit
AU - Thipmontri, Wilawan
AU - Riwlord, Athita
AU - Jirapornchai, Surachai
AU - Runapong, Patcharee
AU - Boonyong, Sutas
AU - Rerknawarat, Pongpol
AU - Surin, Uraiwan
AU - Winichakoon, Poramed
AU - Chaimongkhol, Pisitphon
N1 - Publisher Copyright:
© 2021 Yungyuen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.
PY - 2021/9
Y1 - 2021/9
N2 - 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 extendedspectrum 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.
AB - 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 extendedspectrum 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.
KW - Bla gene
KW - Drug resistance
KW - Gram-negative bacteria
KW - Surveillance
KW - Thailand
UR - https://www.scopus.com/pages/publications/85112850482
U2 - 10.1128/AAC.00675-21
DO - 10.1128/AAC.00675-21
M3 - Article
C2 - 34181474
AN - SCOPUS:85112850482
SN - 0066-4804
VL - 65
JO - Antimicrobial Agents and Chemotherapy
JF - Antimicrobial Agents and Chemotherapy
IS - 9
M1 - e00675-21
ER -
SDG 3 Good Health and Well-being