Bacterial Species and Antimicrobial Resistance of Clinical Isolates from Pediatric Patients in Yangon, Myanmar, 2020

Abstract

Antimicrobial resistance (AMR) is a concern in medical care for children who have high burden of infectious diseases. We investigated the prevalence of bacterial species and their susceptibility to antimicrobials of 1019 clinical isolates from pediatric patients in a tertiary-care hospital in Yangon, Myanmar for one-year period (2020). The most frequently recovered species was Escherichia coli, followed by Klebsiella pneumoniae and Staphylococcus aureus, all of which accounted for 43% of clinical isolates, while 25% of isolates comprised non-fermenter, including Pseudomonas sp. and Acinetobacter sp. Phenotypically determined ESBL (extended-spectrum beta-lactamase)-positive rates in E. coli, K. pneumoniae, and Enterobacter sp. were 82%, 88%, and 65%, respectively. High rates of multiple drug resistance were noted for E. coli (84%), K. pneumoniae (81%), and Acinetobacter sp. (65%), associated with carbapenem resistance in 48%, 42%, and 59% of isolates, respectively. In contrast, S. aureus isolates exhibited low resistance rates (<30%) to most of antimicrobials, with 22% being resistant to oxacillin/cefoxitin. Fluoroquinolone resistance was found in most of bacterial species with different prevalence rates. The present study revealed the current status on prevalence of bacterial species causing infections in pediatric patients in Myanmar, highlighting the significance to monitor AMR among children.

Phenotypic And Genotypic Characterization of Extended Spectrum Beta- Lactamase-Producing Clinical Isolates of Escherichia coli and Klebsiella pneumoniae in Two Kenyan Facilities: A National Referral and a Level Five Hospital

“…However, varied MDR rates among E. coli and K. pneumoniae in hospital settings have been reported globally, where > 50 % MDR againt a considerable range of antibiotics has been observed in Kenya [54], [63], Portugal [69], Canada [70], and Nepal [41]. Despite their collection from similar setups, the varied resistance patterns exhibited by the studied isolates can be attributed to the frequency of speci c antibiotic administration, among other factors such as those reported previously [71], [72]. The lack of proper antimicrobial resistance surveillance and stewardship, compounded by inadequate testing and documentation capacity, may be responsible for the high resistance rates [10], [73].…”

“…Proper surveillance mechanisms are imperative considering the intricate nature of antimicrobial resistance, especially in E. coli and K. pneumoniae, which are notorious sources of nosocomial infections [71], [75], [90]- [92]. Appropriate characterisation of resistance patterns and genetic traits in these enterobacteria may help rede ne treatment regimens and avert further exacerbation and distribution of resistant strains [93].…”

Phenotypic and Genotypic Characterization of Extended Spectrum Beta-Lactamase-Producing Clinical Isolates of Escherichia coli and Klebsiella pneumoniae in Two Kenyan Facilities: A National Referral and a Level Five Hospital

“…However, varied MDR rates among E. coli and K. pneumoniae in hospital settings have been reported globally, where >50% MDR against a considerable range of antibiotics has been observed in Kenya [ 57 , 65 ], Portugal [ 70 ], Canada [ 71 ], and Nepal [ 47 ]. Despite their collection from similar setups, the varied resistance patterns exhibited by the studied isolates can be attributed to the frequency of specific antibiotic administration, among other factors such as those reported previously [ 72 , 73 ]. The lack of proper antimicrobial resistance surveillance and stewardship, compounded by inadequate testing and documentation capacity, may be responsible for the high resistance rates [ 10 , 74 ].…”

“…Proper surveillance mechanisms are imperative considering the intricate nature of antimicrobial resistance, especially in E. coli and K. pneumoniae, which are notorious sources of nosocomial infections [72,76,[91][92][93]. Appropriate characterisation of resistance patterns and genetic traits in these enterobacteria may help redefne treatment regimens and avert further exacerbation and distribution of resistant strains [94].…”

Assessment of the Antibiotic Resistance Characteristics of Staphylococcus aureus Isolated at Da Nang Hospital for Women and Children, Vietnam

“…The highest prevalence of S. aureus was found in pus and blood, similar to other studies. [18][19][20] The highest isolation rate of S. aureus in pus and blood in this study could be partly due to S. aureus is a normal flora of skin that can enter the body through cracks, abrasion, cuts, surgical incisions, burn, and intravenous catheter and causes pyogenic infection. 21 The antimicrobial susceptibility testing in the present study demonstrated high resistance profiles of S. aureus isolates.…”