Antimicrobial susceptibility and distribution of extended-spectrum β-lactamases, AmpC β-lactamases and carbapenemases among Proteus, Providencia and Morganella isolated from global hospitalised patients with intra-abdominal and urinary tract infections: Results of the Study for Monitoring Antimicrobial Resistance Trends (SMART), 2008–2011

Journal of Global Antimicrobial Resistance

Jui-Hsuan Yang¹  Po-Ren Hsueh²  Wang-Huei Sheng² 

[1] Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu City, Taiwan;Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan;

关键词: Intra-abdominal infection;    Urinary tract infection;    Study for Monitoring Antimicrobial Resistance Trends (SMART);    Proteus;    Providencia;    Morganella;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objectives: The increasing trend of β-lactam resistance among Enterobacteriaceae is a worldwide problem. This study investigated isolates of the tribe Proteeae (Proteus, Providencia and Morganella) causing intra-abdominal and urinary tract infections from the worldwide Study for Monitoring Antimicrobial Resistance Trends (SMART) collected from 2008–2011. Methods: Antimicrobial susceptibility testing was performed on isolates with an ertapenem minimum inhibitory concentration >0.5 mg/L or those phenotypically producing extended-spectrum β-lactamases (ESBLs). ESBLs, AmpC β-lactamases and carbapenemases were detected by multiplex PCR. Results: A total of 142 isolates, including Proteus mirabilis (n = 121), Proteus vulgaris (n = 3), Providencia stuartii (n = 5), Providencia rettgeri (n = 6) and Morganella morganii (n = 7), were analysed. Proteus mirabilis was generally susceptible to ertapenem (∼90%) compared with imipenem (≤25%). The most common ESBLs were CTX-M types (n = 64), followed by TEM (n = 27) and SHV (n = 7). CTX-M-1, CTX-M-2 and CTX-M-15 were the dominant CTX-M-type ESBLs in P. mirabilis isolates. CMY (n = 14), which included CMY-2 (n = 6), was the most common AmpC β-lactamase, followed by DHA (n = 6) and FOX (n = 4). NDM (n = 7), which included NDM-1 (n = 4), was the most common carbapenemase, followed by KPC (n = 2). Isolates from hospital-associated infections had more complicated β-lactamase combinations than isolates from community-acquired infections. Conclusion: The global emergence and spread of β-lactamase-producing Proteeae isolates are major issues in tackling antimicrobial resistance. Continuous monitoring of antimicrobial resistance trends and developing further resistance surveillance are necessary.

【 授权许可】

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