Antimicrobial resistance in Cambodia: a review

Reed, Thomas Arthur; Krang, Sidonn; Miliya, Thyl; Townell, Nicola; Letchford, Joanne; Sreng, Bun; Sar, Borann; Osbjer, Kristina; Seng, Sokerya; Chou, Monidarin; By, Youlet; Vanchinsuren, Lkhagvadorj; Nov, Vandarith; Chau, Damon; Phe, Thong; Lauzanne, Agathe de; Ly, Sovann; Turner, Paul

doi:10.1016/j.ijid.2019.05.036

Cited by 38 publications

(23 citation statements)

References 59 publications

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“…Besides, there is high variability among the criteria relevant to methodology and interpretation. This is consonant with the data depicted elsewhere in recent similar reviews [77,78,86,90]. There are some calls to adopt standardized AMR data presented in published papers, wishing to make the ndings interpretable and comparable from the perspective of scarce homogeneity [111].…”

Section: Discussionsupporting

confidence: 79%

“…In China, the overall carbapenem-resistant Enterobacteriaceae infection incidence per 10 000 discharges was 4.0 and varies signi cantly by region [85]. However, no carbapenem-resistant Enterobacteriaceae was found in a recent systematic review from Cambodia [86]. Carbapenemases have a global distribution, but substantial variability exists at the regional and continental levels.…”

Section: Discussionmentioning

confidence: 99%

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Antimicrobial Resistance Among GLASS Pathogens In Morocco: An Epidemiological Scoping Review

Nejjari

Achhab²,

Benaouda

et al. 2022

Preprint

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Background: Monitoring of antimicrobial resistance (AMR) is of great importance due to the frequency of strains becoming increasingly resistant to antibiotics. This review, using a public health focused approach, aimed to understand and describe the current status of AMR in Morocco in relation to WHO priority pathogens and treatment guidelines.Methods: PubMed, ScienceDirect and Google Scholar Databases and grey literature were searched published articles on antimicrobial drug resistance data for GLASS priority pathogens isolated from Morocco between January 2011 and December 2021. Articles were screened using strict inclusion/exclusion criteria. AMR data was extracted with medians and IQR of resistance rates.Results: Forty-nine articles were included in the final analysis. The most reported bacterium was Escherichia coli with median resistance rates of 90.9%, 64.0%, 56.0%, 47.8%, 34.4%, 34.0%, and 23.0% for amoxicillin, amoxicillin-clavulanic acid, co-trimoxazole, nalidixic acid, ceftriaxone, fluoroquinolones, and gentamicin, respectively. Colistin had the lowest median resistance with 0.1% (range 0.0-11.9).Conclusions: Whilst resistance rates are high for most of GLASS pathogens, there were deficient data to draw vigorous conclusions about the current status AMR in Morocco. The recently join to the GLASS system surveillance will begin to address this data gap.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance Among GLASS Pathogens In Morocco: An Epidemiological Scoping Review

Nejjari

Achhab²,

Benaouda

et al. 2022

Preprint

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“…This result was expected since FQ is one of the most commonly used antibiotics in non-TB infections in Cambodia and the drug is accessible without prescription at the counter of pharmacies. 39 High incidence of FQ-resistance has also been reported in many parts of the world, particularly in countries with a high TB burden. 40 FQ is used in both the standardized and shorter MDR-TB regimen and is considered as an essential part of the MDR-TB regimen.…”

Section: Discussionmentioning

confidence: 99%

Resistance to Second-Line Anti-TB Drugs in Cambodia: A Phenotypic and Genetic Study

Cheng¹,

Hide²,

Pheng³

et al. 2021

IDR

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Background: Due to the emergence of Mycobacterium tuberculosis (M.tb) clinical isolates resistant to most potent first-line drugs (FLD), second-line drugs (SLD) are being prescribed more frequently. We explore the genetic characteristics and molecular mechanisms of M.tb isolates phenotypically resistant to SLD, including pre-extensively drug-resistant (pre-XDR) and extensively drug-resistant (XDR) isolates. Methods: Drug-resistant (DR) M.tb isolates collected from 2012 to 2017 were tested using sequencing and phenotypic drug susceptibility testing. Genotypes were determined to explore their links with SLD resistance patterns. Results: Of the 272 DR M.tb isolates, 6 non-multidrug resistant (non-MDR) isolates were fluoroquinolones (FQ)-resistant, 3 were XDR and 16 were pre-XDR (14 resistant to FQ and 2 to second-line injectable drugs). The most frequent mutations in FQ-resistant and secondline injectable drugs resistant isolates were gyrA D94G (15/23) and rrs a1401g (3/5), respectively. Seventy-five percent of pre-XDR isolates and 100% of XDR isolates harbored mutations conferring resistance to pyrazinamide. All XDR isolates belonged to the Beijing genotype, of which one, named XDR+, was resistant to all drugs tested. One cluster including pre-XDR and XDR isolates was observed. Conclusion: This is the first description of SLD resistance in Cambodia. The data suggest that the proportion of XDR and pre-XDR isolates remains low but is on the rise compared to previous reports. The characterization of the XDR+ isolate in a patient who refused treatment underlines the risk of transmission in the population. In addition, genotypic results show, as expected, that the Beijing family is the main involved in pre-XDR and XDR isolates and that the spread of the Beijing pre-XDR strain is capable of evolving into XDR strain. This study strongly indicates the need for rapid interventions in terms of diagnostic and treatment to prevent the spread of the pre-XDR and XDR strains and the emergence of more resistant ones.

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“…A recent systematic review of 24 studies published between 2000 and 2018 reported resistance rates for selected pathogens in Cambodia (118). The median resistance rates, calculated by combining all specimens, were reported in this study.…”

Section: Cambodiamentioning

confidence: 90%

Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

Alvarez-Uria²,

et al. 2020

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SUMMARY Antimicrobial resistance (AMR) is a serious global health threat and is predicted to cause significant health and economic impacts, particularly in low- and middle-income countries (LMICs). AMR surveillance is critical in LMICs due to high burden of bacterial infections; however, conducting AMR surveillance in resource-limited settings is constrained by poorly functioning health systems, scarce financial resources, and lack of skilled personnel. In 2015, the United Nations World Health Assembly endorsed the World Health Organization’s Global Action Plan to tackle AMR; thus, several countries are striving to improve their AMR surveillance capacity, including making significant investments and establishing and expanding surveillance networks. Initial data generated from AMR surveillance networks in LMICs suggest the high prevalence of resistance, but these data exhibit several shortcomings, such as a lack of representativeness, lack of standardized laboratory practices, and underutilization of microbiology services. Despite significant progress, AMR surveillance networks in LMICs face several challenges in expansion and sustainability due to limited financial resources and technical capacity. This review summarizes the existing health infrastructure affecting the establishment of AMR surveillance programs, the burden of bacterial infections demonstrating the need for AMR surveillance, and current progress and challenges in AMR surveillance efforts in eight South and Southeast Asian countries.

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Antimicrobial resistance in Cambodia: a review

Cited by 38 publications

References 59 publications

Antimicrobial Resistance Among GLASS Pathogens In Morocco: An Epidemiological Scoping Review

Antimicrobial Resistance Among GLASS Pathogens In Morocco: An Epidemiological Scoping Review

Resistance to Second-Line Anti-TB Drugs in Cambodia: A Phenotypic and Genetic Study

Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

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