scholarly journals Antimicrobial resistance of major clinical pathogens in South Korea, May 2016 to April 2017: first one-year report from Kor-GLASS

2018 ◽  
Vol 23 (42) ◽  
Author(s):  
Hyukmin Lee ◽  
Eun-Jeong Yoon ◽  
Dokyun Kim ◽  
Seok Hoon Jeong ◽  
Eun Jeong Won ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Surveillance System ◽  
Bacterial Species ◽  
Bloodstream Infections ◽  
First Year ◽  
E Coli ◽  
Antimicrobial Susceptibility Tests ◽  
One Year ◽  
Susceptibility Tests ◽  
Tract Infections

The Korean government established an antimicrobial resistance (AMR) surveillance system, compatible with the Global AMR Surveillance System (GLASS): Kor-GLASS. We describe results from the first year of operation of the Kor-GLASS from May 2016 to April 2017, comprising all non-duplicated clinical isolates of major pathogens from blood, urine, faeces and urethral and cervical swabs from six sentinel hospitals. Antimicrobial susceptibility tests were carried out by disk diffusion, Etest, broth microdilution and agar dilution methods. Among 67,803 blood cultures, 3,523 target pathogens were recovered. The predominant bacterial species were Escherichia coli (n = 1,536), Klebsiella pneumoniae (n = 597) and Staphylococcus aureus (n = 584). From 57,477 urine cultures, 6,394 E. coli and 1,097 K. pneumoniae were recovered. Bloodstream infections in inpatients per 10,000 patient-days (10TPD) were highest for cefotaxime-resistant E. coli with 2.1, followed by 1.6 for meticillin-resistant Sta. aureus, 1.1 for imipenem-resistant Acinetobacter baumannii, 0.8 for cefotaxime-resistant K. pneumoniae and 0.4 for vancomycin-resistant Enterococcus faecium. Urinary tract infections in inpatients were 7.7 and 2.1 per 10TPD for cefotaxime-resistant E. coli and K. pneumoniae, respectively. Kor-GLASS generated well-curated surveillance data devoid of collection bias or isolate duplication. A bacterial bank and a database for the collections are under development.

scholarly journals 1457. Antimicrobial Resistance of Urinary Tract Infection Pathogens in South Korea: A Surveillance Report of the One-Year Assessment in 2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S532-S533
Author(s):  
Changseung Liu ◽  
Eun-Jeong Yoon ◽  
Dokyun Kim ◽  
Jong Hee Shin ◽  
Jeong Hwan Shin ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Tract Infection ◽  
Surveillance System ◽  
Resistance Rate ◽  
E Coli ◽  
One Year ◽  
The One ◽  
Tract Infections

Abstract Background Korean Antimicrobial Surveillance System (Kor-GLASS) was established in 2016, which is compatible with the Global Antimicrobial Resistance Surveillance System launched by WHO. Here, we report a one-year assessment of Kor-GLASS in 2017, focusing on the antimicrobial resistance of urine isolates. Methods Non-duplicated clinical isolates of E. coli and K. pneumoniae recovered from urine cultures were collected from 8 sentinel hospitals. Demographic information, infection origin (hospital origin or community origin), and admission type were investigated. Bacterial species were confirmed using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometer. Antimicrobial susceptibility was tested by disk diffusion and broth microdilution methods. Results During the one-year period of surveillance from January 2017 to December 2017, a total of 9,130 (11.9%) isolates of target pathogens were recovered from urine specimens of 76,625 patients with suspected urinary tract infection (UTI). The rate of culture-positive was the highest in the < 1 age group (AG) (22.5%), stiffly decreased in the 5–<15 AG to 3.4%, and gradually increased with age up to 19.6% in the ≥ 85 AG. The mean occurrence of UTI per 10,000 patient-days for inpatients was 19.3 (range, 3.4–46.1) for E. coli and 4.0 (range, 1.5–7.3) for K. pneumoniae. Resistance rate for cefotaxime was higher than those for ceftazidime both in E. coli (31.3% vs. 10.3%) and K. pneumoniae isolates (39.0% vs. 29.8%). Resistance rate for ciprofloxacin in E. coli isolates was 40.9%, and that in K. pneumoniae isolates was 31.9%. Only 4.9% and 10.9% of E. coli and K. pneumoniae isolates exhibited resistance phenotype to cefoxitin, respectively. Ertapenem-resistance was more frequently identified in K. pneumoniae isolates (1.6%) than in E. coli isolates (0.1%). Multidrug-resistance (MDR) phenotype was identified in 61.4% of the E. coli and 44.8% of K. pneumoniae urine isolates. Conclusion Kor-GLASS generated well-curated surveillance data devoid of collection bias or isolate duplication. Cefoxitin was an alternative treatment to ciprofloxacin for urinary tract infections caused by Enterobacteriaceae. About one-half of urine isolates belonged to either MDR or XDR. Disclosures All authors: No reported disclosures.

scholarly journals Overview of three-year trends of antimicrobial consumption and resistance in Sicilian hospitals

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Barchitta ◽  
A Quattrocchi ◽  
A Maugeri ◽  
M C La Rosa ◽  
C La Mastra ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Surveillance System ◽  
Action Plan ◽  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
Antimicrobial Consumption ◽  
Antimicrobial Susceptibility Tests ◽  
Susceptibility Tests ◽  
Resistance Rates

Abstract Background Antimicrobial resistance (AMR) is one of the ten threats identified by the WHO in 2019. In order to face this issue and in the framework of the National Action Plan on Antimicrobial Resistance (PNCAR) 2017-2020, the Sicilian Health Authority has implemented a surveillance system of antibiotic consumption in the hospital sector and in the community and of antibiotic resistance in the Sicilian hospitals. The aim of the present work is to report the results of three-year surveillance. Methods From 2015 to 2017, data on antibiotic consumption have been collected from pharmacies of participating hospitals. AMR data on seven bacterial pathogens isolated in blood and cerebrospinal fluid have been collected from hospital laboratories, using routine clinical antimicrobial susceptibility tests. Antibiotic consumption was expressed as Defined Daily Dose (DDD) per 100 patient-days. Antibiotic resistance rates (RRs) were calculated as the number of non-susceptible isolates divided by the total number of isolates multiplied by 100. Results The most commonly consumed antibiotics in participating hospitals were fluoroquinolones in 2015, penicillins in 2016, and beta-lactams in 2017, respectively. RRs of Klebsiella pneumoniae significantly increased for all antimicrobial classes (p &lt; 0.001), but carbapenems. By contrast, RRs of Escherichia coli resistant to third-generation cephalosporins and carbapenems showed significant decreasing trends (p &lt; 0.001). Conclusions The implementation of the Sicilian surveillance system provides Sicilian reference data to monitor trends and target interventions and policies for reducing the threat of AMR. Recently, using toolkits of the ECDC-EAAD initiative adapted with regional surveillance data, an educational campaign “Obiettivo Antibiotico” - https://www.obiettivoantibiotico.it/ - was designed and launched to raise awareness of prudent use of antibiotics in the general public and in healthcare professionals in Sicily. Key messages Inappropriate antimicrobial consumption observed in Sicilian hospitals contributes to the emergence and selection of AMR. Surveillance system of antimicrobial consumption and AMR can help identify strategies for preventing spread of multi-drug resistant microorganisms.

scholarly journals Whole-Genome Sequencing for Molecular Characterization of Carbapenem-Resistant Enterobacteriaceae Causing Lower Urinary Tract Infection among Pediatric Patients

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 972
Author(s):  
Hassan Al Mana ◽  
Sathyavathi Sundararaju ◽  
Clement K. M. Tsui ◽  
Andres Perez-Lopez ◽  
Hadi Yassine ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Bacterial Species ◽  
Whole Genome ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Tract Infections ◽  
Carbapenem Resistant Enterobacteriaceae

Antibiotic resistance is a growing public health problem globally, incurring health and cost burdens. The occurrence of antibiotic-resistant bacterial infections has increased significantly over the years. Gram-negative bacteria display the broadest resistance range, with bacterial species expressing extended-spectrum β-lactamases (ESBLs), AmpC, and carbapenemases. All carbapenem-resistant Enterobacteriaceae (CRE) isolates from pediatric urinary tract infections (UTIs) between October 2015 and November 2019 (n = 30). All isolates underwent antimicrobial resistance phenotypic testing using the Phoenix NMIC/ID-5 panel, and carbapenemase production was confirmed using the NG-Test CARBA 5 assay. Whole-genome sequencing was performed on the CREs. The sequence type was identified using the Achtman multi-locus sequence typing scheme, and antimicrobial resistance markers were identified using ResFinder and the CARD database. The most common pathogens causing CRE UTIs were E. coli (63.3%) and K. pneumoniae (30%). The most common carbapenemases produced were OXA-48-like enzymes (46.6%) and NDM enzymes (40%). Additionally, one E. coli harbored IMP-26, and two K. pneumoniae possessed mutations in ompK37 and/or ompK36. Lastly, one E. coli had a mutation in the marA porin and efflux pump regulator. The findings highlight the difference in CRE epidemiology in the pediatric population compared to Qatar’s adult population, where NDM carbapenemases are more common.

scholarly journals Microbial Predominance and Antimicrobial Resistance in a Tertiary Hospital: A Six-year Retrospective study from Outpatients and Patients Visiting the Emergency Department

2020 ◽  
Author(s):  
CaiFeng Wang ◽  
Wen Li ◽  
Juanjuan Gao ◽  
Dancheng Zhang ◽  
Yali Li ◽  
...  
Keyword(s):  
Emergency Department ◽  
Retrospective Study ◽  
Antimicrobial Resistance ◽  
Tertiary Hospital ◽  
Diffusion Method ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Antimicrobial Susceptibility Tests ◽  
Susceptibility Tests

Abstract Objective: To assessing the characteristics of of microbial species and the antimicrobial resistance in a Tertiary Hospital with 49 outpatient clinics and emergency department in Northwestern China, of six years. Methods: A retrospective study was conducted using HIS database of a tertiary hospital between the full-year period of 2013 and 2018. Antimicrobial susceptibility tests were conducted by automated systems and/or the Kary-Bauer disc diffusion method. Data were analyzed using the WHONET 5.6 software. The Cochran–Armitage test was used to study the trends over the period. Results: A total of 19,028 specimens were submitted for the laboratory tests of microbiology. Among 49 units, only Emergency Department and Kidney Transplantation Clinic with the number of submission showed a significant increase annually (P<0.001). A total of 3,849 non-repetitive isolates were identified, covering more than 200 species, of which gram-positive cocci accounted for 46.4% and gram-negative bacilli 45.3%. The methicillin-resistant rates of S. aureus and S. epidermidis were 25.1% and 74.6%, respectively. The isolates of 60.9% of E. coli and 33.5% of K. pneumonia contained extended spectrum β lactamases. Moreover, there were no Staphylococci and Enterococci resistant to linezolid, vancomycin and tigecycline. In addition, the percentages of E. coli, K. pneumonia and P. aeruginosa isolates resistant to carbapenems were low (0.0%, 1.1% and 18.7%, respectively). Conclusion: Vancomycin, linezolid and tigecycline are among the most effective treatment for outpatients with gram-positive infection. Carbapenems are among the most effective for gram-negative infection. There is no significant annual increase of common multidrug resistances.

scholarly journals Antimicrobial resistance surveillance: can we estimate resistance in bloodstream infections from other types of specimen?

2020 ◽  
Author(s):  
Karina-Doris Vihta ◽  
Nicola Claire Gordon ◽  
Nicole Stoesser ◽  
T. Phuong Quan ◽  
Carina SB Tyrrell ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Low Income ◽  
Bloodstream Infections ◽  
Cost Effective ◽  
Middle Income ◽  
E Coli ◽  
Middle Income Countries ◽  
Invasive Infections ◽  
Tract Infections ◽  
Over Time

SynopsisBackgroundAntimicrobial resistance (AMR) surveillance of bloodstream infections is challenging in low- and middle-income countries (LMICs), limited laboratory capacity preventing routine patient-level susceptibility testing. Other specimen types could provide an effective approach to surveillance.ObjectivesOur study aims to systematically evaluate the relationship between resistance prevalence in non-sterile sites and bloodstream infections.MethodsAssociations between resistance rates in Escherichia coli and Staphylococcus aureus isolates from blood and other specimens were estimated in Oxfordshire, UK, 1998-2018, comparing proportions resistant in each calendar year using time series cross-correlations and across drug-years. We repeated analysis across publicly-available data from four high-income and 12 middle-income countries, and in three hospitals/programmes in LMICs.Results8102 E. coli bloodstream infections, 322087 E. coli urinary tract infections, 6952 S. aureus bloodstream infections and 112074 S. aureus non-sterile site cultures were included from Oxfordshire. Resistance trends over time in blood versus other specimens were strongly correlated (maximum cross-correlation 0.51-0.99, strongest associations in the same year for 18/27 pathogen-drug combinations). Resistance prevalence was broadly congruent across drug-years for each species. 276/312 (88%) species-drug-years had resistance prevalence in other specimen types within ±10% of that blood isolates. Results were similar across multiple countries and hospitals/programmes in high/middle/low income-settings.ConclusionsResistance in bloodstream and less invasive infections are strongly related over time, suggesting the latter could be a surveillance tool for AMR in LMICs. These infection sites are easier to sample and cheaper to obtain the necessary numbers of susceptibility tests, providing more cost-effective evidence for decisions including empiric antibiotic recommendations.

scholarly journals Antimicrobial resistance patterns of commensal Escherichia coli isolated from feces of non-diarrheic dogs in Grenada, West Indies

2019 ◽  
Vol 12 (12) ◽  
pp. 2070-2075 ◽  
Author(s):  
Victor A. Amadi ◽  
Harry Hariharan ◽  
Ozioma A. Amadi ◽  
Vanessa Matthew-Belmar ◽  
Roxanne Nicholas-Thomas ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Resistance Rate ◽  
Resistance Pattern ◽  
E Coli ◽  
Resistance Patterns ◽  
Antimicrobial Susceptibility Tests ◽  
Susceptibility Tests ◽  
Selection Of

Background and Aim: There is currently no published information on the prevalence and antimicrobial susceptibility patterns of commensal Escherichia coli in dogs of Grenada origin. Monitoring antimicrobial resistance helps in the empirical selection of antibiotics. This study determined the occurrence of E. coli including the O157:H7 serotype in feces of non-diarrheic dogs of Grenada origin and the antibiotic resistance pattern of the E. coli isolates. Materials and Methods: Fecal samples from 142 of the 144 (98.6%) dogs were culture positive for E. coli. Selection of up to three colonies from each of the 142 E. coli-positive samples yielded a total of 402 E. coli isolates, which were analyzed for the presence of non-sorbitol fermenting colonies, and O157-agglutination. Results: Of the 402 E. coli isolates, 30 (7.5%) were non-sorbitol fermenters. However, none of the 402 isolates gave a positive reaction (O157:H7) to the E. coli O157:H7 latex kit. Antimicrobial susceptibility tests against 12 antibiotics revealed low resistance rates to all the tested antibiotics except for tetracycline (Te) (23.4%), cephalothin (CF) (13.2%), and ampicillin (AM) (7.7%). Thirty-nine out of the 402 (9.7%), E. coli isolates were resistant to two or more antibiotics of different classes. Conclusion: This is the first report of isolation and antimicrobial susceptibilities of commensal E. coli from non-diarrheic dogs in Grenada. Some of the isolates (39/402 isolates, 9.7%) were resistant to multiple antibiotics. This study showed that presently, dogs in Grenada should not be considered a reservoir for the E. coli O157:H7 serotype and for multiple antibiotic-resistant E. coli strains. Among the 402 E. coli isolates, the resistance rate to drugs other than Te, CF, and AM was very low.

scholarly journals Antimicrobial resistance in commensal opportunistic pathogens isolated from non-sterile sites can be an effective proxy for surveillance in bloodstream infections

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Karina-Doris Vihta ◽  
Nicola Claire Gordon ◽  
Nicole Stoesser ◽  
T. Phuong Quan ◽  
Carina S. B. Tyrrell ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Low Income ◽  
Bloodstream Infections ◽  
Opportunistic Pathogens ◽  
Calendar Time ◽  
Middle Income ◽  
E Coli ◽  
Laboratory Capacity ◽  
Low Middle Income Countries ◽  
Tract Infections

AbstractAntimicrobial resistance (AMR) surveillance in bloodstream infections (BSIs) is challenging in low/middle-income countries (LMICs) given limited laboratory capacity. Other specimens are easier to collect and process and are more likely to be culture-positive. In 8102 E. coli BSIs, 322,087 E. coli urinary tract infections, 6952 S. aureus BSIs and 112,074 S. aureus non-sterile site cultures from Oxfordshire (1998–2018), and other (55,296 isolates) rarer commensal opportunistic pathogens, antibiotic resistance trends over time in blood were strongly associated with those in other specimens (maximum cross-correlation per drug 0.51–0.99). Resistance prevalence was congruent across drug-years for each species (276/312 (88%) species-drug-years with prevalence within ± 10% between blood/other isolates). Results were similar across multiple countries in high/middle/low income-settings in the independent ATLAS dataset (103,559 isolates, 2004–2017) and three further LMIC hospitals/programmes (6154 isolates, 2008–2019). AMR in commensal opportunistic pathogens cultured from BSIs is strongly associated with AMR in commensal opportunistic pathogens cultured from non-sterile sites over calendar time, suggesting the latter could be used as an effective proxy for AMR surveillance in BSIs.

scholarly journals Antimicrobial resistance of Escherichiacoli and Salmonella isolated from retail broiler chicken carcasses in Zambia

2021 ◽  
Vol 6 (1) ◽  
pp. 35
Author(s):  
Elizabeth Muligisa-Muonga ◽  
Geoffrey Mainda ◽  
Mercy Mukuma ◽  
Geoffrey Kwenda ◽  
Bernard Hang’ombe ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Foodborne Pathogens ◽  
Broiler Chicken ◽  
Health Concern ◽  
Public Health Concern ◽  
E Coli ◽  
Antimicrobial Susceptibility Tests ◽  
Susceptibility Tests ◽  
Open Markets

Antimicrobial resistance (AMR) of foodborne pathogens is of public health concern, especially in developing countries such as Zambia. This study was undertaken to determine the antimicrobial resistance profiles of Escherichia coli (E. coli) and Salmonella isolated from retail broiler chicken carcasses purchased from open markets and supermarkets in Zambia. A total of 189 E. coli and five Salmonella isolates were isolated. Identification and confirmation of the isolates were done using Analytical Profile Index (API 20E) (Biomerieux®) and 16S rRNA sequencing. Antimicrobial susceptibility tests (AST) were performed using the Kirby Bauer disk diffusion technique using a panel of 9 antibiotics. WHONET 2018 software was used to analyze AST results. The E. coli isolates were mostly resistant to tetracycline (79.4%), ampicillin (51.9%), and trimethoprim/sulfamethoxazole (49.7%). Two of the five Salmonella isolates were resistant to at least one antibiotic. This study has demonstrated the presence of AMR E. coli and Salmonella on retail broiler chicken carcasses from open markets and supermarkets, which is of public health concern.

scholarly journals Comparison of de-duplication methods used by WHO Global Antimicrobial Resistance Surveillance System (GLASS) and Japan Nosocomial Infections Surveillance (JANIS) in the surveillance of antimicrobial resistance

2020 ◽  
Author(s):  
Toshiki Kajihara ◽  
Koji Yahara ◽  
John Stelling ◽  
Sergey Romualdovich Eremin ◽  
Barbara Tornimbene ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Nosocomial Infections ◽  
Surveillance System ◽  
Bacterial Species ◽  
World Health ◽  
Surveillance Period ◽  
E Coli ◽  
Specimen Type ◽  
Antimicrobial Resistance Surveillance ◽  
Number Of Patients

AbstractA major issue in the surveillance of antimicrobial resistance (AMR) is “de-duplication” or removal of repeated isolates, for which there exist multiple methods. The World Health Organization (WHO) Global Antimicrobial Resistance Surveillance System (GLASS) requires de-duplication by selecting only the first isolate of a given bacterial species per patient per surveillance period per specimen type per age group, gender, and infection origin stratification. However, no study on the comparative application of this method has been reported. The objective of this study was to evaluate differences in data tabulation between the WHO GLASS and the Japan Nosocomial Infections Surveillance (JANIS) system, which counts both patients and isolates after removing repeated isolates of the same bacterial species per multiresistance phenotype isolated from a patient within 30 days, regardless of specimen type. All bacterial data, consisting of approximately 8 million samples from 1795 Japanese hospitals in 2017 were exported from the JANIS database, and were tabulated using either the de-duplication algorithm of GLASS, or JANIS. We compared the tabulated results of the total number of patients whose blood and urine cultures were taken and of the percentage of resistant isolates of Escherichia coli for each priority antibiotic. The number of patients per specimen type tabulated by the JANIS method was always smaller than that of GLASS. There was a small (< 3%) difference in the percentage of resistance of E. coli for any antibiotic between the two methods in both out- and inpatient settings and blood and urine isolates. The two tabulation methods did not show considerable differences in terms of the tabulated percentages of resistance for E. coli. We further discuss how the use of GLASS tabulations to create a public software and website that could help to facilitate the understanding of and treatment against AMR.

scholarly journals Molecular Epidemiology and Characterization of Carbapenem-Resistant Klebsiella pneumoniae Isolated from Urine at a Teaching Hospital in Taiwan

2021 ◽  
Vol 9 (2) ◽  
pp. 271
Author(s):  
Yuarn-Jang Lee ◽  
Chih-Hung Huang ◽  
Noor Andryan Ilsan ◽  
I-Hui Lee ◽  
Tzu-Wen Huang
Keyword(s):  
Klebsiella Pneumoniae ◽  
Teaching Hospital ◽  
Efflux Pump ◽  
Resistance Mechanisms ◽  
Pcr Analysis ◽  
Carbapenem Resistant ◽  
High Prevalence ◽  
Antimicrobial Susceptibility Tests ◽  
Susceptibility Tests ◽  
Tract Infections

Urinary tract infections (UTIs) are common in clinics and hospitals and are associated with a high economic burden. Enterobacterium Klebsiella pneumoniae is a prevalent agent causing UTIs. A high prevalence of carbapenem-resistant K. pneumoniae (CRKP) has emerged recently and is continuing to increase. Seventeen urinary CRKP isolates collected at a teaching hospital in Taiwan from December 2016 to September 2017 were analyzed to elucidate their drug resistance mechanisms. Two-thirds of the isolates were obtained from outpatients. Antimicrobial susceptibility tests demonstrated multidrug resistance in all the isolates. Multilocus sequence typing analysis showed high diversity among the isolates. PCR analysis demonstrated the presence of carbapenemases in three isolates. All isolates carried at least one other extended-spectrum β-lactamase, including TEM, DHA, and CTX-M. Fifteen isolates contained mutations in one of the outer membrane porins that were assessed. The expression levels of the acrB and/or oqxB efflux pump genes, as determined by qRT-PCR, were upregulated in 11 isolates. Six isolates might have utilized other efflux pumps or antimicrobial resistance mechanisms. These analyses demonstrated a highly diverse population and the presence of complex resistance mechanisms in urinary isolates of K. pneumoniae.

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