Publication:
Carbapenem and colistin resistance in Enterobacteriaceae in Southeast Asia: Review and mapping of emerging and overlapping challenges

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Issued Date

2019

Resource Type

Review

File Type

application/pdf

ISSN

9248579

DOI

10.1016/j.ijantimicag.2019.07.019

Other identifier(s)

2-s2.0-85071472165

Rights Holder(s)

Scopus

Bibliographic Citation

International Journal of Antimicrobial Agents. Vol 54, No.4 (2019), p.381-399

Suggested Citation

Malchione M.D., Torres L.M., Hartley D.M., Koch M., Goodman J.L. Carbapenem and colistin resistance in Enterobacteriaceae in Southeast Asia: Review and mapping of emerging and overlapping challenges. International Journal of Antimicrobial Agents. Vol 54, No.4 (2019), p.381-399. doi:10.1016/j.ijantimicag.2019.07.019 Retrieved from: https://hdl.handle.net/20.500.14740/5144

Title

Carbapenem and colistin resistance in Enterobacteriaceae in Southeast Asia: Review and mapping of emerging and overlapping challenges

Author(s)

Malchione M.D.
 Torres L.M.
 Hartley D.M.
 Koch M.
 Goodman J.L.

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

Subject(s)

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

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URI

https://hdl.handle.net/20.500.14740/5144

Collections

Scopus: Year 1983-2021

Endorsement

Review

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