Emergence of high levels of extended-spectrum-beta-lactamase-producing gram-negative bacilli in the Asia-Pacific region: data from the Study for Monitoring Antimicrobial Resistance Trends (SMART) program, 2007.
Of 3,004 gram-negative bacilli collected from intra-abdominal infections in the Asia-Pacific region during 2007, 42.2% and 35.8% of Escherichia coli and Klebsiella spp., respectively, were extended-spectrum beta-lactamase (ESBL) positive. Moreover ESBL rates in India for E. coli, Klebsiella pneumoniae, and Klebsiella oxytoca were 79.0%, 69.4%, and 100%, respectively. ESBL-positive E. coli rates were also relatively high in China (55.0%) and Thailand (50.8%). Ertapenem and imipenem were the most active drugs tested, inhibiting over 90% of all species, including ESBL-positive isolates with the exception of Pseudomonas aeruginosa isolates (<90% susceptible to all study drugs) and ESBL-positive Klebsiella pneumoniae isolates (<90% susceptible to all study drugs except imipenem). Quinolones achieved 90% inhibition levels only against ESBL-negative K. pneumoniae and ESBL-negative K. oxytoca. A decline in ampicillin-sulbactam activity was noted, with only 34.5% of all Enterobacteriaceae inhibited in this study.
Hawser
Stephen P
SP
International Health Management Associates Europe Sàrl, 4 Route de la Corniche, 1066 Epalinges, Switzerland. shawser@ihmainc.com
Bouchillon
Samuel K
SK
Hoban
Daryl J
DJ
Badal
Robert E
RE
Hsueh
Po-Ren
PR
Paterson
David L
DL
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002681:China; D024881:Drug Resistance, Bacterial; D000077727:Ertapenem; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology*; D015378:Imipenem / Q000494:pharmacology; D007194:India; D007709:Klebsiella / Q000187:drug effects / Q000201:enzymology; D015363:Quinolones / Q000494:pharmacology; D013785:Thailand; D001618:beta-Lactamases / Q000378:metabolism*; D047090:beta-Lactams / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D015363:Quinolones; D047090:beta-Lactams; D015378:Imipenem; D001618:beta-Lactamases; D000077727:Ertapenem