title: Characterization of extended-spectrum beta-lactamases and antimicrobial resistance of Klebsiella pneumoniae in intra-abdominal infection isolates in Latin America, 2008-2012. Results of the Study for Monitoring Antimicrobial Resistance Trends.
abstract: The Study for Monitoring Antimicrobial Resistance Trends has monitored the in vitro activity of several recommended antimicrobials used in the management of intra-abdominal infections (IAIs) globally since 2002. In this report, we document the changing susceptibility patterns to recommended antimicrobials in Klebsiella pneumoniae isolates from patients with IAIs in 11 Latin American countries between 2008 and 2012 and describe the beta-lactamases encoded by phenotypically extended-spectrum beta-lactamase (ESBL)-positive and ertapenem-nonsusceptible isolates. Overall, the incidence of phenotypically ESBL-positive K. pneumoniae did not change significantly from 2008 (40.4%) to 2012 (41.2%) (P > 0.05). However, trend analysis documented an increase in isolates encoding K. pneumoniae carbapenemase (KPC) or both KPC and an ESBL. Decreasing susceptibility (P < 0.05) was noted for cefepime, ceftazidime, ceftriaxone, ertapenem, and imipenem among all K. pneumoniae, as well as for cefepime, cefotaxime, cefoxitin, ceftriaxone, ertapenem, and imipenem among ESBL-positive isolates, while susceptibility of ESBL-negative isolates to ampicillin-sulbactam actually increased (P < 0.05).
authors.affiliation: International Health Management Associates Inc., Schaumburg, IL, USA. Electronic address: kkazmierczak@ihmainc.com.
authors.forename: Krystyna M
authors.initials: KM
authors.lastname: Kazmierczak
authors.affiliation: International Health Management Associates Inc., Schaumburg, IL, USA.
authors.forename: Sibylle H
authors.initials: SH
authors.lastname: Lob
authors.affiliation: International Health Management Associates Inc., Schaumburg, IL, USA.
authors.forename: Daryl J
authors.initials: DJ
authors.lastname: Hoban
authors.affiliation: International Health Management Associates Inc., Schaumburg, IL, USA.
authors.forename: Meredith A
authors.initials: MA
authors.lastname: Hackel
authors.affiliation: International Health Management Associates Inc., Schaumburg, IL, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Badal
authors.affiliation: International Health Management Associates Inc., Schaumburg, IL, USA.
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Bouchillon
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D006801:Humans; D015994:Incidence; D059413:Intraabdominal Infections / Q000453:epidemiology / Q000382:microbiology*; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D007843:Latin America / Q000453:epidemiology; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*; D047090:beta-Lactams / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D001618:beta-Lactamases
keywords: Beta-lactamase; Klebsiella pneumoniae; Resistance