Antimicrobial susceptibility of Gram‐negative ESKAPE pathogens isolated from hospitalized patients with intra‐abdominal and urinary tract infections in Asia‐Pacific countries: SMART 2013‐2015. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Karlowsky, James A.; Hoban, Daryl J.; Hackel, Meredith A.; Lob, Sibylle H.; Sahm, Daniel F.
• Is Part Of: Journal of medical microbiology. Volume 66:Issue 1(2017)
• Publication Date: 2017-01
• Subjects: SMART -- surveillance -- imipenem -- ertapenem -- Asia‐Pacific -- ESKAPE pathogens; Medical microbiology -- Periodicals; 616.9041
• DOI: 10.1099/jmm.0.000421
• Languages: English
• ISSNs: 0022-2615

Abstract

Abstract : N/A: Gram‐negative ESKAPE pathogens ( Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) are responsible for increases in antimicrobial‐resistant infections worldwide. We determined in vitro susceptibilities to eight parenteral antimicrobial agents using Clinical and Laboratory Standards Institute broth microdilution methodology for Gram‐negative ESKAPE pathogens isolated from hospitalized patients with intra‐abdominal infections (IAIs) ( n =3052) and urinary tract infections (UTIs) ( n =1088) in 11 Asia‐Pacific countries/regions from 2013 to 2015. Amikacin (98.3, 96.4 %), imipenem (97.1, 95.5 %) and ertapenem (95.3, 93.2 %) demonstrated the highest rates of susceptibility for isolates of K. pneumoniae from IAI and UTI, respectively, whereas susceptibility to advanced‐generation cephalosporins was <84 and <71 %, respectively. K. pneumoniae with an extended‐spectrum β‐lactamase‐positive phenotype were more common in UTI (27.1 %) than IAI (16.2 %). Imipenem and amikacin were the most active agents against extended‐spectrum β‐lactamase‐positive K. pneumoniae from IAI (95.1, 91.8 %) and UTI (94.9, 92.3 %), respectively, whereas <54 % were susceptible to piperacillin‐tazobactam. Against Enterobacter spp. and P. aeruginosa, amikacin demonstrated the highest rates of susceptibility for isolates from IAI (99.7, 95.5 %) and UTI (90.9, 91.5 %), respectively. K. pneumoniae, Enterobacter spp. and P. aeruginosa from urine demonstrated lower susceptibility to levofloxacin (74.1, 81.8 and 73.8 %) than from IAI (87.6, 91.8 and 85.4 %). For A. baumannii, rates of susceptibility to all agents tested were <43 %. We conclude that the studied Gram‐negative ESKAPE pathogens demonstrated reduced susceptibility to commonly prescribed advanced‐generation cephalosporins, piperacillin‐tazobactam and levofloxacin, while amikacin and carbapenems were the most active. Ongoing surveillance to monitor evolving resistance trends and the development of novel antimicrobial agents with potent activity against Gram‐negative ESKAPE pathogens are mandatory.