Prediction of major antibiotic resistance in Escherichia coli and Klebsiella pneumoniae in Singapore, USA and China using a limited set of gene targets.
Antibiotic resistance in Gram-negative bacteria, especially Enterobacteriaceae, can be conferred by a large number of different acquired resistance genes, although it appears that relatively few dominate. A previous survey of Escherichia coli and Klebsiella pneumoniae isolates from Sydney, Australia, revealed that a limited set of genes could reliably predict resistance to third-generation cephalosporins (3GCs) and aminoglycosides. Here we tested E. coli and K. pneumoniae isolates with a cefotaxime, ceftriaxone and/or ceftazidime minimum inhibitory concentration of ≥ 2 μg/mL from China and Singapore, with significantly higher resistance rates than Australia, as well as the USA. Few targets were needed to predict non-susceptibility to 3GCs (95/95; 100%) and gentamicin (47/51; 92%). The gene types detected here are consistent with previous surveys in similar countries with similar resistance rates, where the majority of 3GC resistance can be explained by blaCTX-M genes. This study identified a limited set of genes capable of predicting resistance to 3GC and aminoglycoside antibiotics and implies a restriction in the global resistance gene pool that can be exploited for diagnostic purposes.
Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead Hospital, Sydney, NSW, Australia; Centre for Research Excellence in Critical Infection and Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia; Westmead Millennium Institute, Westmead, NSW, Australia.
Andrew N
AN
Ginn
Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead Hospital, Sydney, NSW, Australia.
Agnieszka M
AM
Wiklendt
Department of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
Zhiyong
Z
Zong
Department of Laboratory Medicine, National University Health System, Singapore; Department of Microbiology and Department of Pathology, National University of Singapore, Singapore.
Raymond T P
RT
Lin
Department of Laboratory Medicine, National University Health System, Singapore.
Jeanette W P
JW
Teo
Department of Medicine, National University of Singapore, Singapore; University Medical Cluster, National University Health System, Singapore.
Paul A
PA
Tambyah
Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, IL, USA; Department of Medicine, NorthShore University HealthSystem, IL, USA; University of Chicago, Pritzker School of Medicine, Chicago, IL, USA.
Lance R
LR
Peterson
Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, IL, USA; University of Chicago, Pritzker School of Medicine, Chicago, IL, USA.
Karen
K
Kaul
Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead Hospital, Sydney, NSW, Australia; Centre for Research Excellence in Critical Infection and Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia; Westmead Millennium Institute, Westmead, NSW, Australia.
Sally R
SR
Partridge
Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead Hospital, Sydney, NSW, Australia; Centre for Research Excellence in Critical Infection and Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia; Westmead Millennium Institute, Westmead, NSW, Australia. Electronic address: jonathan.iredell@sydney.edu.au.
Jonathan R
JR
Iredell
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002439:Cefotaxime / Q000494:pharmacology; D002442:Ceftazidime / Q000494:pharmacology; D002443:Ceftriaxone / Q000494:pharmacology; D002681:China; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology; D005798:Genes, Bacterial; D005839:Gentamicins / Q000494:pharmacology; D006801:Humans; D007710:Klebsiella Infections / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D012846:Singapore; D014481:United States
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002443:Ceftriaxone; D002442:Ceftazidime; D002439:Cefotaxime
Antibiotic resistance; Diagnostic targets; Enterobacteriaceae; Genetic diversity; Global