title: Impact of revised CLSI breakpoints for susceptibility to third-generation cephalosporins and carbapenems among Enterobacteriaceae isolates in the Asia-Pacific region: results from the Study for Monitoring Antimicrobial Resistance Trends (SMART), 2002-2010.
abstract: This study examined the rates of susceptibility to third-generation cephalosporins and carbapenems among Enterobacteriaceae isolates that had been obtained from patients with intraabdominal infections in the Asia-Pacific region as part of the Study for Monitoring Antimicrobial Resistance Trends (SMART). Susceptibility profiles obtained using 2009 Clinical and Laboratory Standards Institute (CLSI) breakpoints were compared with those obtained using the 2011 CLSI breakpoints. From 2002 to 2010, Escherichia coli and Klebsiella pneumoniae together accounted for more than 60% of the 13714 Enterobacteriaceae isolates analyzed during the study period. Extended-spectrum β-lactamase (ESBL) producers comprised 28.2% of E. coli isolates and 22.1% of K. pneumoniae isolates in the Asia-Pacific region, with China (55.6% and 33.7%, respectively) and Thailand (43.1% and 40.7%, respectively) having the highest proportions of ESBL producers. Based on the 2011 CLSI criteria, 77.2% of the Enterobacteriaceae isolates, 40.4% of ESBL-producing E. coli, and 25.2% of ESBL-producing K. pneumoniae isolates were susceptible to ceftazidime. Carbapenems showed in vitro activity against >90% of Enterobacteriaceae isolates in all participating countries, except for ertapenem in South Korea (susceptibility rate 82.2%). Marked differences (>5%) in susceptibility of ESBL-producing E. coli and K. pneumoniae isolates to carbapenems were noted between the profiles obtained using the 2009 CLSI criteria and those using the 2011 CLSI criteria. Continuous monitoring of antimicrobial resistance is necessary in the Asia-Pacific region.
authors: Department of Internal Medicine, National Cheng Kung University Hospital, No. 138, Sheng Li Road, Tainan 704, Taiwan.
authors: Chi-Chang
authors: CC
authors: Huang
authors: Yao-Shen
authors: YS
authors: Chen
authors: Han-Siong
authors: HS
authors: Toh
authors: Yu-Lin
authors: YL
authors: Lee
authors: Yuag-Meng
authors: YM
authors: Liu
authors: Cheng-Mao
authors: CM
authors: Ho
authors: Po-Liang
authors: PL
authors: Lu
authors: Chun-Eng
authors: CE
authors: Liu
authors: Yen-Hsu
authors: YH
authors: Chen
authors: Jen-Hsien
authors: JH
authors: Wang
authors: Hung-Jen
authors: HJ
authors: Tang
authors: Kwok-Woon
authors: KW
authors: Yu
authors: Yung-Ching
authors: YC
authors: Liu
authors: Yin-Ching
authors: YC
authors: Chuang
authors: Yingchun
authors: Y
authors: Xu
authors: Yuxing
authors: Y
authors: Ni
authors: Wen-Chien
authors: WC
authors: Ko
authors: Po-Ren
authors: PR
authors: Hsueh
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001208:Asia / Q000453:epidemiology; D044362:Australasia / Q000453:epidemiology; D015780:Carbapenems / Q000494:pharmacology*; D002511:Cephalosporins / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification / Q000472:pathogenicity; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology; D000077727:Ertapenem; D006801:Humans; D059413:Intraabdominal Infections / Q000453:epidemiology / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D011446:Prospective Studies; D001618:beta-Lactamases / Q000096:biosynthesis; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D047090:beta-Lactams; D001618:beta-Lactamases; D000077727:Ertapenem