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Title: | Carbapenem and colistin resistance in Enterobacteriaceae in Southeast Asia: Review and mapping of emerging and overlapping challenges |
Authors: | Malchione M.D. Torres L.M. Hartley D.M. Koch M. Goodman J.L. |
Keywords: | carbapenem colistin metallo beta lactamase polymyxin antibiotic sensitivity bacterial gene bacterium isolate Brunei Darussalam Cambodia carbapenem resistance colistin resistance drug classification Escherichia coli genotype human Indonesia infection control infection risk Klebsiella Laos Malaysia mcr 1 gene Myanmar NDM gene nonhuman OXA gene Philippines priority journal Review Singapore Thailand Timor-Leste Viet Nam World Health Organization |
Issue Date: | 2019 |
Abstract: | Carbapenem-resistant Enterobacteriaceae infections have spread globally, leaving polymyxins, including colistin, as ‘last-resort treatments’. Emerging colistin resistance raises the spectre of untreatable infections. Despite this threat, data remain limited for much of the world, including Southeast Asia where only 3 of 11 nations submitted data on carbapenem and colistin resistance for recent World Health Organization (WHO) reports. To improve our understanding of the challenge, we utilised broad strategies to search for and analyse data on carbapenem and colistin resistance among Escherichia coli and Klebsiella in Southeast Asia. We found 258 studies containing 526 unique reports and document carbapenem-resistant E. coli and Klebsiella in 8 and 9 of 11 nations, respectively. We estimated carbapenem resistance proportions through meta-analysis of extracted data for nations with ≥100 representative isolates. Estimated resistance among Klebsiella was high (>5%) in four nations (Indonesia, Philippines, Thailand and Vietnam), moderate (1–5%) in two nations (Malaysia and Singapore) and low (<1%) in two nations (Cambodia and Brunei). For E. coli, resistance was generally lower but was high in two of seven nations with ≥100 isolates (Indonesia and Myanmar). The most common carbapenemases were NDM metallo-β-lactamases and OXA β-lactamases. Despite sparse data, polymyxin resistance was documented in 8 of 11 nations, with mcr-1 being the predominant genotype. Widespread presence of carbapenem and polymyxin resistance, including their overlap in eight nations, represents a continuing risk and increases the threat of infections resistant to both classes. These findings, and remaining data gaps, highlight the urgent need for sufficiently-resourced robust antimicrobial resistance surveillance. © 2019 |
URI: | https://ir.swu.ac.th/jspui/handle/123456789/12294 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85071472165&doi=10.1016%2fj.ijantimicag.2019.07.019&partnerID=40&md5=8a47ce543cf82f8e056779c212175ecd |
ISSN: | 9248579 |
Appears in Collections: | Scopus 1983-2021 |
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