Affiliation:
1. The Eastern Regional Health Authority, Trinidad and Tobago
Abstract
Background
The Centres for Disease Control and Prevention (CDC) and World Health Organization (WHO) list extended spectrum beta-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae as serious threats and priority pathogens. This study identified phenotypic resistance patterns to these pathogens in east Trinidad, West Indies. We also aimed to set up and test a pilot surveillance system aligned to WHO’s Global Antimicrobial Surveillance System (WHO-GLASS).
Methods
Two key bacterial isolates, Escherichia coli and Klebsiella pneumoniae were used and one specimen, blood, was used to test a pilot surveillance system. Data for resistance patterns, for Sangre Grande Hospital (SGH), for ESBL producing E. coli and K. pneumoniae were downloaded from the Microscan Autoscan© for the period 2013 – 2016. ESBL presence in bacteria resistant to Cefotaxime (CTX), Ceftazidime (CAZ) and Ceftriaxone (CRO) were recorded. Data were stored in a Microsoft Excel© spreadsheet and inputted into IBM© SPSSv22. Data were displayed as resistance percentages for the year. No patient data were collected. Simple descriptive statistics were used.
Results
The number of organisms recovered from the database for the period 2013 to 2016 were:134E. coli and 59K. pneumoniae. Phenotypic resistance rates for ESBLs for 2013 to 2016 were:
Ecoli:
2013: Resistance ranged from 22.2-29.6% with maximum resistance seen for CTX.
2014: Resistance ranged from 12.9- 22.2%, with maximum resistance seen for CRO.
2015: Resistance ranged from 21.4- =26.2%, with maximum resistance seen for CTX.
2016: Resistance ranged from 29.4- 32.4%, with maximum resistance seen for CRO and CTX.
K pneumoniae:
2013: Resistance was 40% for all 3rd generation Cephalosporins.
2014: Resistance was 16.7% for all 3rd generation Cephalosporins.
2015: Resistance was 16.7% for all 3rd generation Cephalosporins.
2016: Resistance ranged from 52.6 – 63.2%, with maximum resistance seen for CAZ.
Conclusion
Phenotypic resistance rates in K. pneumoniae and E. coli were generally high. There was an overall increase in resistance from 2013 to 2016 for both K. pneumoniae and E. coli with greater resistance being seen in K. pneumoniae.
Publisher
Trinidad and Tobago Medical Association
Subject
General Earth and Planetary Sciences,General Engineering,General Environmental Science
Reference20 articles.
1. World Health Organization. Global Priority List of Antibiotic-Resistant Bacteria to Guide Research, Discovery, and Development of new Antibiotics. https://www.who.int/medicines/publications/WHO-PPL-Short_Summary_25Feb-ET_NM_WHO.pdf?ua=1 (Accessed 10/01/2019).
2. Centres for Disease Control and Prevention. Antibiotic / Antimicrobial Resistance (AR / AMR). 2020. https://www.cdc.gov/drugresistance/biggest-threats.html#extend (Accessed30/08/ 2020).
3. Nepal K, Pant ND, Neupane B, Belbase A, Baidhya R, Shrestha RK et al. Extended spectrum beta-lactamase and metallo beta-lactamase production among Escherichia coli and Klebsiella pneumoniae isolated from different clinical samples in a tertiary care hospital in Kathmandu, Nepal. Ann Clin Microbiol Antimicrob. 2017; 16(1):62.
4. Chong Y, Shimoda S, Shimono N et al. Current epidemiology, genetic evolution and clinical impact of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Infect Genet Evol. 2018; 61:185-188.
5. Heinz E, Brindle R, Morgan-McCalla A, Peters K, Thomson NR. Caribbean multi-centre study of Klebsiella pneumoniae: whole-genome sequencing, antimicrobial resistance and virulence factors. MicrobGenom. 2019;5(5): e000266. doi:10.1099/mgen.0.000266.
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献