CARBAPENEM-SPARING ANTIBIOTIC TREATMENT OPTIONS FOR HOSPITAL-ACQUIRED K. PNEUMONIAE AND P. AERUGINOSA RESPIRATORY-TRACT INFECTIONS FROM MALAYSIA SMART STUDY 2017-2020
Intro: This study aims to determine the Gram-negative pathogens distribution in hospital-acquired (HA) (≥48 hours from admission date) respiratory tract infections (RTI) and the antibiotics susceptibility against the common Gramnegative pathogens. We report ceftolozane/tazobactam (C/T) and various a...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971223002874 |
| _version_ | 1827945263905374208 |
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| author | P. Thangarajah Y. Khoo M. Othman Z. Mohamed H. Suhaimi N.M.N. Nik Samsudin |
| author_facet | P. Thangarajah Y. Khoo M. Othman Z. Mohamed H. Suhaimi N.M.N. Nik Samsudin |
| author_sort | P. Thangarajah |
| collection | DOAJ |
| description | Intro: This study aims to determine the Gram-negative pathogens distribution in hospital-acquired (HA) (≥48 hours from admission date) respiratory tract infections (RTI) and the antibiotics susceptibility against the common Gramnegative pathogens. We report ceftolozane/tazobactam (C/T) and various antibiotics susceptibility against K. pneumoniae and P. aeruginosa isolated from HA-ICU and non-ICU wards across Malaysia. Methods: Total of 902 Gram-negative-HA-RTI pathogens were collected from 2017-2020 across 5 Malaysia SMART sites. Of which, 517 from non-ICU and 334 from ICU were collected and susceptibility was compared between non-ICU and ICU isolates against top two most prevalent pathogen, K. pneumoniae and P. aeruginosa. MICs were determined using broth microdilution and interpreted with CLSI breakpoints. The Gram-negative pathogens were tested against ceftazidime (CAZ), ceftriaxone (CRO), cefepime (FEP), piperacillin/tazobactam (P/T), ceftolozane/tazobactam (C/T), meropenem (MEM) and imipenem (IMI). Findings: K. pneumoniae and P. aeruginosa continue to be the top two Gram negative pathogens in RTI including those hospital-acquired. In HA-RTI, P. aeruginosa contributed 28% of pathogen distribution in both isolates collected from non-ICU and ICU wards. The distribution of K. pneumoniae markedly decreased in ICU at 29.9% compared to non-ICU at 48.7%. K. pneumoniae showed decreased susceptibility to almost all non-carbapenem antibiotics including CAZ, CRO, FEP, P/T ranging from 63.89% - 80.56% in non-ICU isolates to 51.0% - 65.0% for ICU isolates. C/T maintained susceptibility at 85.71% in non-ICU isolates and 70.0% in ICU isolates. P. aeruginosa similarly showed decreased susceptibility against CAZ, FEP, P/T ranging from 83.45% - 88.97% in non-ICU isolates to 74.74% – 84.21% in ICU isolates, while C/T maintained susceptibility at 96.55% in non-ICU isolates and 94.74% in ICU isolates. Conclusion: Study highlights decreased susceptibility of K. pneumonia and P. aeruginosa in HA-ICU isolates. C/T maintained high susceptibility against both pathogens in ICU and non-ICU and may be considered a carbapenem-sparing option if carbapenem-resistant Acinetobacter is not suspected. |
| first_indexed | 2024-03-13T10:41:06Z |
| format | Article |
| id | doaj.art-89dbe5ba6c9d4e67bcfdfbaee031bec0 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-03-13T10:41:06Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-89dbe5ba6c9d4e67bcfdfbaee031bec02023-05-18T04:38:28ZengElsevierInternational Journal of Infectious Diseases1201-97122023-05-01130S63CARBAPENEM-SPARING ANTIBIOTIC TREATMENT OPTIONS FOR HOSPITAL-ACQUIRED K. PNEUMONIAE AND P. AERUGINOSA RESPIRATORY-TRACT INFECTIONS FROM MALAYSIA SMART STUDY 2017-2020P. Thangarajah0Y. Khoo1M. Othman2Z. Mohamed3H. Suhaimi4N.M.N. Nik Samsudin5Hospital Melaka, Pathology, Melaka, MalaysiaMSD Singapore, GMSA, Singapore, SingaporeHospital Melaka, Pathology, Melaka, MalaysiaHospital Melaka, Pathology, Melaka, MalaysiaHospital Melaka, Pathology, Melaka, MalaysiaHospital Melaka, Pathology, Melaka, MalaysiaIntro: This study aims to determine the Gram-negative pathogens distribution in hospital-acquired (HA) (≥48 hours from admission date) respiratory tract infections (RTI) and the antibiotics susceptibility against the common Gramnegative pathogens. We report ceftolozane/tazobactam (C/T) and various antibiotics susceptibility against K. pneumoniae and P. aeruginosa isolated from HA-ICU and non-ICU wards across Malaysia. Methods: Total of 902 Gram-negative-HA-RTI pathogens were collected from 2017-2020 across 5 Malaysia SMART sites. Of which, 517 from non-ICU and 334 from ICU were collected and susceptibility was compared between non-ICU and ICU isolates against top two most prevalent pathogen, K. pneumoniae and P. aeruginosa. MICs were determined using broth microdilution and interpreted with CLSI breakpoints. The Gram-negative pathogens were tested against ceftazidime (CAZ), ceftriaxone (CRO), cefepime (FEP), piperacillin/tazobactam (P/T), ceftolozane/tazobactam (C/T), meropenem (MEM) and imipenem (IMI). Findings: K. pneumoniae and P. aeruginosa continue to be the top two Gram negative pathogens in RTI including those hospital-acquired. In HA-RTI, P. aeruginosa contributed 28% of pathogen distribution in both isolates collected from non-ICU and ICU wards. The distribution of K. pneumoniae markedly decreased in ICU at 29.9% compared to non-ICU at 48.7%. K. pneumoniae showed decreased susceptibility to almost all non-carbapenem antibiotics including CAZ, CRO, FEP, P/T ranging from 63.89% - 80.56% in non-ICU isolates to 51.0% - 65.0% for ICU isolates. C/T maintained susceptibility at 85.71% in non-ICU isolates and 70.0% in ICU isolates. P. aeruginosa similarly showed decreased susceptibility against CAZ, FEP, P/T ranging from 83.45% - 88.97% in non-ICU isolates to 74.74% – 84.21% in ICU isolates, while C/T maintained susceptibility at 96.55% in non-ICU isolates and 94.74% in ICU isolates. Conclusion: Study highlights decreased susceptibility of K. pneumonia and P. aeruginosa in HA-ICU isolates. C/T maintained high susceptibility against both pathogens in ICU and non-ICU and may be considered a carbapenem-sparing option if carbapenem-resistant Acinetobacter is not suspected.http://www.sciencedirect.com/science/article/pii/S1201971223002874 |
| spellingShingle | P. Thangarajah Y. Khoo M. Othman Z. Mohamed H. Suhaimi N.M.N. Nik Samsudin CARBAPENEM-SPARING ANTIBIOTIC TREATMENT OPTIONS FOR HOSPITAL-ACQUIRED K. PNEUMONIAE AND P. AERUGINOSA RESPIRATORY-TRACT INFECTIONS FROM MALAYSIA SMART STUDY 2017-2020 International Journal of Infectious Diseases |
| title | CARBAPENEM-SPARING ANTIBIOTIC TREATMENT OPTIONS FOR HOSPITAL-ACQUIRED K. PNEUMONIAE AND P. AERUGINOSA RESPIRATORY-TRACT INFECTIONS FROM MALAYSIA SMART STUDY 2017-2020 |
| title_full | CARBAPENEM-SPARING ANTIBIOTIC TREATMENT OPTIONS FOR HOSPITAL-ACQUIRED K. PNEUMONIAE AND P. AERUGINOSA RESPIRATORY-TRACT INFECTIONS FROM MALAYSIA SMART STUDY 2017-2020 |
| title_fullStr | CARBAPENEM-SPARING ANTIBIOTIC TREATMENT OPTIONS FOR HOSPITAL-ACQUIRED K. PNEUMONIAE AND P. AERUGINOSA RESPIRATORY-TRACT INFECTIONS FROM MALAYSIA SMART STUDY 2017-2020 |
| title_full_unstemmed | CARBAPENEM-SPARING ANTIBIOTIC TREATMENT OPTIONS FOR HOSPITAL-ACQUIRED K. PNEUMONIAE AND P. AERUGINOSA RESPIRATORY-TRACT INFECTIONS FROM MALAYSIA SMART STUDY 2017-2020 |
| title_short | CARBAPENEM-SPARING ANTIBIOTIC TREATMENT OPTIONS FOR HOSPITAL-ACQUIRED K. PNEUMONIAE AND P. AERUGINOSA RESPIRATORY-TRACT INFECTIONS FROM MALAYSIA SMART STUDY 2017-2020 |
| title_sort | carbapenem sparing antibiotic treatment options for hospital acquired k pneumoniae and p aeruginosa respiratory tract infections from malaysia smart study 2017 2020 |
| url | http://www.sciencedirect.com/science/article/pii/S1201971223002874 |
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