Distribution of β-lactamases and emergence of carbapenemases co-occurring Enterobacterales isolates with high-level antibiotic resistance identified from patients with intra-abdominal infection in the Asia–Pacific region, 2015–2018
Purpose: In this study, we aimed to assess the geographic distribution and molecular characteristics of β-lactamases among Enterobacterales isolates causing intra-abdominal infections (IAIs) from 2015 to 2018 in the Asia–Pacific region. Method: Isolates were investigated for extended-spectrum β-lact...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Journal of Microbiology, Immunology and Infection |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118221001468 |
| _version_ | 1797995175037894656 |
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| author | Yu-Chin Chen Wei-Yu Chen Wei-Yun Hsu Hung-Jen Tang Yun Chou Yi-Hsin Chang Chi-Chung Chen Yin-Ching Chuang Tu-Hsuan Chang |
| author_facet | Yu-Chin Chen Wei-Yu Chen Wei-Yun Hsu Hung-Jen Tang Yun Chou Yi-Hsin Chang Chi-Chung Chen Yin-Ching Chuang Tu-Hsuan Chang |
| author_sort | Yu-Chin Chen |
| collection | DOAJ |
| description | Purpose: In this study, we aimed to assess the geographic distribution and molecular characteristics of β-lactamases among Enterobacterales isolates causing intra-abdominal infections (IAIs) from 2015 to 2018 in the Asia–Pacific region. Method: Isolates were investigated for extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases, and carbapenemases using multiplex PCR assays and full-gene DNA sequencing. Result: A total of 832 Enterobacterales isolates from 8 different countries with β-lactamase genes were analysed. Plasmid-mediated ESBLs and AmpC β-lactamases were encoded in 598 (71.9 %) and 314 (37.7 %) isolates, respectively. In 710 (85.3 %) carbapenemase-negative isolates, positivity for both AmpC β-lactamases and ESBLs was identified in 51 (8.5 %) Escherichia coli and 24 (3.4 %) Klebsiella pneumoniae isolates. The most prevalent countries were Taiwan and Vietnam, and the co-occurrence of CMY/CTX-M in E. coli and DHA-1/ESBLs in K. pneumoniae was predominant. All isolates showed high susceptibility to colistin, but susceptibility to carbapenems varied among different resistance mechanism combinations. Among 122 (14.7 %) isolates encoding carbapenemase, NDM (n = 67, including 64.2 % NDM-1) was the most common, followed by the OXA-48-type (n = 49), KPC (n = 24) and IMP (n = 4). The most prevalent country was Thailand (n = 44), followed by Vietnam (n = 35) and the Philippines (n = 21). Twenty-two isolates were found to encode multiple carbapenemases, 16 of which were collected from Thailand and harbored NDM-1, OXA-232 and CTX-M-15. Despite high susceptibility to amikacin, susceptibility to colistin was only 56 %. Conclusion: The emergence of carbapenem-non-susceptible AmpC/ESBL co-occurring Enterobacterales and colistin non-susceptible carbapenemases co-occurring K. pneumoniae highlights potential therapeutic challenges in the Asia–Pacific region. |
| first_indexed | 2024-04-11T09:57:15Z |
| format | Article |
| id | doaj.art-6c981b79af9149adbc5a7a33a8f8e7f9 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-04-11T09:57:15Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-6c981b79af9149adbc5a7a33a8f8e7f92022-12-22T04:30:32ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822022-12-0155612631272Distribution of β-lactamases and emergence of carbapenemases co-occurring Enterobacterales isolates with high-level antibiotic resistance identified from patients with intra-abdominal infection in the Asia–Pacific region, 2015–2018Yu-Chin Chen0Wei-Yu Chen1Wei-Yun Hsu2Hung-Jen Tang3Yun Chou4Yi-Hsin Chang5Chi-Chung Chen6Yin-Ching Chuang7Tu-Hsuan Chang8Department of Pediatrics, Chi Mei Medical Center, Chiali, Tainan, TaiwanDepartment of Pediatrics, Chi Mei Medical Center, Tainan, TaiwanDepartment of Pediatrics, Chi Mei Medical Center, Tainan, TaiwanDepartment of Internal Medicine, Chi Mei Medical Center, Tainan, TaiwanDepartment of Pediatrics, Chi Mei Medical Center, Tainan, TaiwanDepartment of Pediatrics, Chi Mei Medical Center, Tainan, TaiwanDepartment of Medical Research, Chi Mei Medical Center, Tainan, Taiwan; Department of Food Science, National Chiayi University, Chiayi, TaiwanDepartment of Medical Research, Chi Mei Medical Center, Tainan, TaiwanDepartment of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Corresponding author. Department of Pediatrics, Chi Mei Medical Center, No.901, Zhonghua Rd., Yongkang Dist., Tainan City, 710, Taiwan. Fax: +886 6 220-3706.Purpose: In this study, we aimed to assess the geographic distribution and molecular characteristics of β-lactamases among Enterobacterales isolates causing intra-abdominal infections (IAIs) from 2015 to 2018 in the Asia–Pacific region. Method: Isolates were investigated for extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases, and carbapenemases using multiplex PCR assays and full-gene DNA sequencing. Result: A total of 832 Enterobacterales isolates from 8 different countries with β-lactamase genes were analysed. Plasmid-mediated ESBLs and AmpC β-lactamases were encoded in 598 (71.9 %) and 314 (37.7 %) isolates, respectively. In 710 (85.3 %) carbapenemase-negative isolates, positivity for both AmpC β-lactamases and ESBLs was identified in 51 (8.5 %) Escherichia coli and 24 (3.4 %) Klebsiella pneumoniae isolates. The most prevalent countries were Taiwan and Vietnam, and the co-occurrence of CMY/CTX-M in E. coli and DHA-1/ESBLs in K. pneumoniae was predominant. All isolates showed high susceptibility to colistin, but susceptibility to carbapenems varied among different resistance mechanism combinations. Among 122 (14.7 %) isolates encoding carbapenemase, NDM (n = 67, including 64.2 % NDM-1) was the most common, followed by the OXA-48-type (n = 49), KPC (n = 24) and IMP (n = 4). The most prevalent country was Thailand (n = 44), followed by Vietnam (n = 35) and the Philippines (n = 21). Twenty-two isolates were found to encode multiple carbapenemases, 16 of which were collected from Thailand and harbored NDM-1, OXA-232 and CTX-M-15. Despite high susceptibility to amikacin, susceptibility to colistin was only 56 %. Conclusion: The emergence of carbapenem-non-susceptible AmpC/ESBL co-occurring Enterobacterales and colistin non-susceptible carbapenemases co-occurring K. pneumoniae highlights potential therapeutic challenges in the Asia–Pacific region.http://www.sciencedirect.com/science/article/pii/S1684118221001468Carbapenemaseβ-lactamaseCo-occurrenceEnterobacteralesAsia–Pacific |
| spellingShingle | Yu-Chin Chen Wei-Yu Chen Wei-Yun Hsu Hung-Jen Tang Yun Chou Yi-Hsin Chang Chi-Chung Chen Yin-Ching Chuang Tu-Hsuan Chang Distribution of β-lactamases and emergence of carbapenemases co-occurring Enterobacterales isolates with high-level antibiotic resistance identified from patients with intra-abdominal infection in the Asia–Pacific region, 2015–2018 Journal of Microbiology, Immunology and Infection Carbapenemase β-lactamase Co-occurrence Enterobacterales Asia–Pacific |
| title | Distribution of β-lactamases and emergence of carbapenemases co-occurring Enterobacterales isolates with high-level antibiotic resistance identified from patients with intra-abdominal infection in the Asia–Pacific region, 2015–2018 |
| title_full | Distribution of β-lactamases and emergence of carbapenemases co-occurring Enterobacterales isolates with high-level antibiotic resistance identified from patients with intra-abdominal infection in the Asia–Pacific region, 2015–2018 |
| title_fullStr | Distribution of β-lactamases and emergence of carbapenemases co-occurring Enterobacterales isolates with high-level antibiotic resistance identified from patients with intra-abdominal infection in the Asia–Pacific region, 2015–2018 |
| title_full_unstemmed | Distribution of β-lactamases and emergence of carbapenemases co-occurring Enterobacterales isolates with high-level antibiotic resistance identified from patients with intra-abdominal infection in the Asia–Pacific region, 2015–2018 |
| title_short | Distribution of β-lactamases and emergence of carbapenemases co-occurring Enterobacterales isolates with high-level antibiotic resistance identified from patients with intra-abdominal infection in the Asia–Pacific region, 2015–2018 |
| title_sort | distribution of β lactamases and emergence of carbapenemases co occurring enterobacterales isolates with high level antibiotic resistance identified from patients with intra abdominal infection in the asia pacific region 2015 2018 |
| topic | Carbapenemase β-lactamase Co-occurrence Enterobacterales Asia–Pacific |
| url | http://www.sciencedirect.com/science/article/pii/S1684118221001468 |
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