Antimicrobial susceptibility and extended-spectrum beta-lactamase rates in aerobic gram-negative bacteria causing intra-abdominal infections in Vietnam: report from the Study for Monitoring Antimicrobial Resistance Trends (SMART 2009–2011)

Biedenbach, Douglas J.; Bouchillon, S.; Hoban, Daryl J.; Hackel, Meredith; Phuong, Doan Mai; Nga, Tran Thi Thanh; Phuong, Nguyen Tran My; Phuong, Tran Thi; Badal, R.

doi:10.1016/j.diagmicrobio.2014.05.009

Cited by 32 publications

(28 citation statements)

References 24 publications

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“…As been clearly demonstrated in many other recent reports, MDROs (particularly P aeruginosa , ESBLs, and MRSA) should be suspected even in community-onset IAI [10, 27–29]. According to our analyses, empiric coverage of MDRO is specifically important and justified among the elderly with an active malignancy.…”

Section: Discussionsupporting

confidence: 69%

Intra-abdominal Infections: The Role of Anaerobes, Enterococci, Fungi, and Multidrug-Resistant Organisms

Marcus¹,

Lévy

Salhab³

et al. 2016

Open Forum Infectious Diseases

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Background.Intra-abdominal infections (IAI) constitute a common reason for hospitalization. However, there is lack of standardization in empiric management of (1) anaerobes, (2) enterococci, (3) fungi, and (4) multidrug-resistant organisms (MDRO). The recommendation is to institute empiric coverage for some of these organisms in “high-risk community-acquired” or in “healthcare-associated” infections (HCAI), but exact definitions are not provided.Methods.Epidemiological study of IAI was conducted at Assaf Harofeh Medical Center (May–November 2013). Logistic and Cox regressions were used to analyze predictors and outcomes of IAI, respectively. The performances of established HCAI definitions to predict MDRO-IAI upon admission were calculated by receiver operating characteristic (ROC) curve analyses.Results.After reviewing 8219 discharge notes, 253 consecutive patients were enrolled (43 [17%] children). There were 116 patients with appendicitis, 93 biliary infections, and 17 with diverticulitis. Cultures were obtained from 88 patients (35%), and 44 of them (50%) yielded a microbiologically confirmed IAI: 9% fungal, 11% enterococcal, 25% anaerobic, and 34% MDRO. Eighty percent of MDRO-IAIs were present upon admission, but the area under the ROC curve of predicting MDRO-IAI upon admission by the commonly used HCAI definitions were low (0.73 and 0.69). Independent predictors for MDRO-IAI were advanced age and active malignancy.Conclusions.Multidrug-resistant organism-IAIs are common, and empiric broad-spectrum coverage is important among elderly patients with active malignancy, even if the infection onset was outside the hospital setting, regardless of current HCAI definitions. Outcomes analyses suggest that empiric regimens should routinely contain antianaerobes (except for biliary IAI); however, empiric antienterococcal or antifungals regimens are seldom needed.

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Section: Discussionsupporting

confidence: 69%

Intra-abdominal Infections: The Role of Anaerobes, Enterococci, Fungi, and Multidrug-Resistant Organisms

Marcus¹,

Lévy

Salhab³

et al. 2016

Open Forum Infectious Diseases

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“…Another study from hospitals of Jordan recognized that the prevalence of ESBLs producing E. coli and K. pneumoniae was 10.8 and 34.0 %, respectively [14]. A similar study from Vietnam has also detected ESBLs in 48.1 % of gram-negative bacilli associated IAIs [3]. Data from Spain demonstrated ESBLs in 7.5 % of Enterobacteriaceae associated IAIs [15].…”

Section: Discussionmentioning

confidence: 99%

“…The reported incidence rate is about 2-9 % [2]. Gram-negative bacilli, especially extendedspectrum β-lactamases (ESBLs) producing bacteria, are the most serious causes of these IAIs [3]. The burden of these IAIs is complicated by trends of increasing antimicrobial resistance and relatively fewer effective antimicrobials.…”

Section: Introductionmentioning

confidence: 99%

Bacteriology and antimicrobial susceptibility of ESBLs producers from pus in patients with abdominal trauma associated intra-abdominal infections

Fan

Wang

et al. 2016

Eur J Trauma Emerg Surg

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Escherichia coli and K. pneumoniae were the major pathogens causing abdominal trauma associated IAIs. The most active agents against ESBLs producing E. coli and K. pneumoniae were ertapenem and imipenem. However, the ESBLs rates were alarmingly high and increasing among IAIs associated gram-negative bacilli infections in China, and most agents exhibited decreased susceptibility against ESBLs producing pathogens.

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“…The prevalence of CRE, including CP-CRE, is high in the tertiary hospitals of the larger South Asian countries (10, 53, 62-71, 75, 82, 83, 99, 101, 102) but much lower in similar hospitals in Southeast Asia (74,114,120,121,129,134,142,147,149,150,157,161). As seen by the numerous reports of CP-CRE exportation from South and Southeast Asia (6,174,(176)(177)(178)(179)(180)(181)(182)(183)(184), international dissemination of CP-CRE appears to be a far greater problem than that of CRAB, and it will conceivably be more difficult for other countries to control CP-CRE within their own borders if this is also not tackled at its root in South and Southeast Asia.…”

Section: Discussionmentioning

confidence: 99%

“…Up to 1.1% of Enterobacteriaceae isolated between 2010 and 2012 were found to be CRE in a surgical hospital in Hanoi (149). Finally, in a separate study looking at Gram-negative bacteria associated with intra-abdominal infections in four hospitals in Vietnam (2009 to 2011), 0.3% (787 isolates) of E. coli isolates and 1% (145 isolates) of K. pneumoniae isolates were found to be carbapenem resistant, but it is not clear how systematic the collection of isolates for the study was (150).…”

Section: Vietnam There Is No National or Regional Antimicrobial Resimentioning

confidence: 99%

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

et al. 2017

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SUMMARY Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth. A complex combination of factors such as inappropriate prescription of antibiotics, overstretched health systems, and international travel (including the phenomenon of medical tourism) probably led to the rapid rise and spread of these bacteria in hospitals in South and Southeast Asia. In India, Pakistan, and Vietnam, carbapenem-resistant Enterobacteriaceae have also been found in the environment and community, likely as a consequence of poor environmental hygiene and sanitation. Considerable political will and effort, including from countries outside these regions, are vital in order to reduce the prevalence of such bacteria in South and Southeast Asia and prevent their global spread.

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Antimicrobial susceptibility and extended-spectrum beta-lactamase rates in aerobic gram-negative bacteria causing intra-abdominal infections in Vietnam: report from the Study for Monitoring Antimicrobial Resistance Trends (SMART 2009–2011)

Cited by 32 publications

References 24 publications

Intra-abdominal Infections: The Role of Anaerobes, Enterococci, Fungi, and Multidrug-Resistant Organisms

Intra-abdominal Infections: The Role of Anaerobes, Enterococci, Fungi, and Multidrug-Resistant Organisms

Bacteriology and antimicrobial susceptibility of ESBLs producers from pus in patients with abdominal trauma associated intra-abdominal infections

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

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