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

Antimicrob Agents Chemother. 2009 Aug;53(8):3280-4. doi: 10.1128/AAC.00426-09. Epub 2009 Jun 8.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • China
  • Drug Resistance, Bacterial
  • Ertapenem
  • Escherichia coli / drug effects
  • Escherichia coli / enzymology
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / enzymology*
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Negative Bacterial Infections / microbiology*
  • Imipenem / pharmacology
  • India
  • Klebsiella / drug effects
  • Klebsiella / enzymology
  • Quinolones / pharmacology
  • Thailand
  • beta-Lactamases / metabolism*
  • beta-Lactams / pharmacology

Substances

  • Anti-Bacterial Agents
  • Quinolones
  • beta-Lactams
  • Imipenem
  • beta-Lactamases
  • Ertapenem