A multicentre study to determine the in vitro efficacy of flomoxef against extended-spectrum beta-lactamase producing Escherichia coli in Malaysia
Background The high burden of extended-spectrum beta-lactamase-producing (ESBL)-producing Enterobacterales worldwide, especially in the densely populated South East Asia poses a significant threat to the global transmission of antibiotic resistance. Molecular surveillance of ESBL-producing pathogens...
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2023-11-01
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| author | Polly Soo Xi Yap Chun Wie Chong Sasheela Ponnampalavanar Ramliza Ramli Azian Harun Tengku Zetty Maztura Tengku Jamaluddin Anis Ahmed Khan Soo Tein Ngoi Yee Qing Lee Min Yi Lau Shiang Chiet Tan Zhi Xian Kong Jia Jie Woon Siew Thong Mak Kartini Abdul Jabar Rina Karunakaran Zalina Ismail Sharifah Azura Salleh Siti Suraiya Md Noor Siti Norbaya Masri Niazlin Mohd Taib Azmiza Syawani Jasni Loong Hua Tee Kin Chong Leong Victor Kok Eow Lim Sazaly Abu Bakar Cindy Shuan Ju Teh |
| author_facet | Polly Soo Xi Yap Chun Wie Chong Sasheela Ponnampalavanar Ramliza Ramli Azian Harun Tengku Zetty Maztura Tengku Jamaluddin Anis Ahmed Khan Soo Tein Ngoi Yee Qing Lee Min Yi Lau Shiang Chiet Tan Zhi Xian Kong Jia Jie Woon Siew Thong Mak Kartini Abdul Jabar Rina Karunakaran Zalina Ismail Sharifah Azura Salleh Siti Suraiya Md Noor Siti Norbaya Masri Niazlin Mohd Taib Azmiza Syawani Jasni Loong Hua Tee Kin Chong Leong Victor Kok Eow Lim Sazaly Abu Bakar Cindy Shuan Ju Teh |
| author_sort | Polly Soo Xi Yap |
| collection | DOAJ |
| description | Background The high burden of extended-spectrum beta-lactamase-producing (ESBL)-producing Enterobacterales worldwide, especially in the densely populated South East Asia poses a significant threat to the global transmission of antibiotic resistance. Molecular surveillance of ESBL-producing pathogens in this region is vital for understanding the local epidemiology, informing treatment choices, and addressing the regional and global implications of antibiotic resistance. Methods Therefore, an inventory surveillance of the ESBL-Escherichia coli (ESBL-EC) isolates responsible for infections in Malaysian hospitals was conducted. Additionally, the in vitro efficacy of flomoxef and other established antibiotics against ESBL-EC was evaluated. Results A total of 127 non-repetitive ESBL-EC strains isolated from clinical samples were collected during a multicentre study performed in five representative Malaysian hospitals. Of all the isolates, 33.9% were isolated from surgical site infections and 85.8% were hospital-acquired infections. High rates of resistance to cefotaxime (100%), cefepime (100%), aztreonam (100%) and trimethoprim-sulfamethoxazole (100%) were observed based on the broth microdilution test. Carbapenems remained the most effective antibiotics against the ESBL-EC, followed by flomoxef. Antibiotic resistance genes were identified by PCR. The blaCTX-M-1 was the most prevalent ESBL gene, with 28 isolates (22%) harbouring blaCTX-M-1 only, 27 isolates (21.3%) co-harbouring blaCTX-M-1 and blaTEM, and ten isolates (7.9%) co-harbouring blaCTX-M-1, blaTEM and blaSHV. A generalised linear model showed significant antibacterial activity of imipenem against different types of infection. Besides carbapenems, this study also demonstrated a satisfactory antibacterial activity of flomoxef (81.9%) on ESBL-EC, regardless of the types of ESBL genes. |
| first_indexed | 2024-03-09T13:55:43Z |
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| spelling | doaj.art-116fe85dfd58455fa2580d2f980836342023-11-30T15:05:09ZengPeerJ Inc.PeerJ2167-83592023-11-0111e1639310.7717/peerj.16393A multicentre study to determine the in vitro efficacy of flomoxef against extended-spectrum beta-lactamase producing Escherichia coli in MalaysiaPolly Soo Xi Yap0Chun Wie Chong1Sasheela Ponnampalavanar2Ramliza Ramli3Azian Harun4Tengku Zetty Maztura Tengku Jamaluddin5Anis Ahmed Khan6Soo Tein Ngoi7Yee Qing Lee8Min Yi Lau9Shiang Chiet Tan10Zhi Xian Kong11Jia Jie Woon12Siew Thong Mak13Kartini Abdul Jabar14Rina Karunakaran15Zalina Ismail16Sharifah Azura Salleh17Siti Suraiya Md Noor18Siti Norbaya Masri19Niazlin Mohd Taib20Azmiza Syawani Jasni21Loong Hua Tee22Kin Chong Leong23Victor Kok Eow Lim24Sazaly Abu Bakar25Cindy Shuan Ju Teh26Jeffrey Cheah School of Medicine and Health Science, Monash University Malaysia, Bandar Sunway, Selangor, MalaysiaSchool of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, MalaysiaDepartment of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, MalaysiaDepartment of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, MalaysiaSchool of Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, MalaysiaDepartment of Anesthesiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, MalaysiaDepartment of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, MalaysiaDepartment of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, MalaysiaDepartment of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, MalaysiaShionogi Singapore, Singapore, SingaporeShionogi Singapore, Singapore, SingaporeSchool of Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, MalaysiaTropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya, Kuala Lumpur, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaBackground The high burden of extended-spectrum beta-lactamase-producing (ESBL)-producing Enterobacterales worldwide, especially in the densely populated South East Asia poses a significant threat to the global transmission of antibiotic resistance. Molecular surveillance of ESBL-producing pathogens in this region is vital for understanding the local epidemiology, informing treatment choices, and addressing the regional and global implications of antibiotic resistance. Methods Therefore, an inventory surveillance of the ESBL-Escherichia coli (ESBL-EC) isolates responsible for infections in Malaysian hospitals was conducted. Additionally, the in vitro efficacy of flomoxef and other established antibiotics against ESBL-EC was evaluated. Results A total of 127 non-repetitive ESBL-EC strains isolated from clinical samples were collected during a multicentre study performed in five representative Malaysian hospitals. Of all the isolates, 33.9% were isolated from surgical site infections and 85.8% were hospital-acquired infections. High rates of resistance to cefotaxime (100%), cefepime (100%), aztreonam (100%) and trimethoprim-sulfamethoxazole (100%) were observed based on the broth microdilution test. Carbapenems remained the most effective antibiotics against the ESBL-EC, followed by flomoxef. Antibiotic resistance genes were identified by PCR. The blaCTX-M-1 was the most prevalent ESBL gene, with 28 isolates (22%) harbouring blaCTX-M-1 only, 27 isolates (21.3%) co-harbouring blaCTX-M-1 and blaTEM, and ten isolates (7.9%) co-harbouring blaCTX-M-1, blaTEM and blaSHV. A generalised linear model showed significant antibacterial activity of imipenem against different types of infection. Besides carbapenems, this study also demonstrated a satisfactory antibacterial activity of flomoxef (81.9%) on ESBL-EC, regardless of the types of ESBL genes.https://peerj.com/articles/16393.pdfExtended-spectrum beta-lactamase (ESBL)Escherichia coliAntimicrobial resistanceFlomoxefEnterobacteralesSurgical site infection |
| spellingShingle | Polly Soo Xi Yap Chun Wie Chong Sasheela Ponnampalavanar Ramliza Ramli Azian Harun Tengku Zetty Maztura Tengku Jamaluddin Anis Ahmed Khan Soo Tein Ngoi Yee Qing Lee Min Yi Lau Shiang Chiet Tan Zhi Xian Kong Jia Jie Woon Siew Thong Mak Kartini Abdul Jabar Rina Karunakaran Zalina Ismail Sharifah Azura Salleh Siti Suraiya Md Noor Siti Norbaya Masri Niazlin Mohd Taib Azmiza Syawani Jasni Loong Hua Tee Kin Chong Leong Victor Kok Eow Lim Sazaly Abu Bakar Cindy Shuan Ju Teh A multicentre study to determine the in vitro efficacy of flomoxef against extended-spectrum beta-lactamase producing Escherichia coli in Malaysia PeerJ Extended-spectrum beta-lactamase (ESBL) Escherichia coli Antimicrobial resistance Flomoxef Enterobacterales Surgical site infection |
| title | A multicentre study to determine the in vitro efficacy of flomoxef against extended-spectrum beta-lactamase producing Escherichia coli in Malaysia |
| title_full | A multicentre study to determine the in vitro efficacy of flomoxef against extended-spectrum beta-lactamase producing Escherichia coli in Malaysia |
| title_fullStr | A multicentre study to determine the in vitro efficacy of flomoxef against extended-spectrum beta-lactamase producing Escherichia coli in Malaysia |
| title_full_unstemmed | A multicentre study to determine the in vitro efficacy of flomoxef against extended-spectrum beta-lactamase producing Escherichia coli in Malaysia |
| title_short | A multicentre study to determine the in vitro efficacy of flomoxef against extended-spectrum beta-lactamase producing Escherichia coli in Malaysia |
| title_sort | multicentre study to determine the in vitro efficacy of flomoxef against extended spectrum beta lactamase producing escherichia coli in malaysia |
| topic | Extended-spectrum beta-lactamase (ESBL) Escherichia coli Antimicrobial resistance Flomoxef Enterobacterales Surgical site infection |
| url | https://peerj.com/articles/16393.pdf |
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