β-Lactam Resistance in Upper Respiratory Tract Pathogens Isolated from a Tertiary Hospital in Malaysia

Abstract

The rise of antimicrobial resistance (AMR) among clinically important bacteria, including respiratory pathogens, is a growing concern for public health worldwide. Common causative bacteria for upper respiratory tract infections (URTIs) include Streptococcus pneumoniae and Haemophilus influenzae, and sometimes Staphylococcus aureus. We assessed the β-lactam resistant trends and mechanisms of 150 URTI strains isolated in a tertiary care hospital in Kuala Lumpur Malaysia. High rates of non-susceptibility to penicillin G (38%), amoxicillin-clavulanate (48%), imipenem (60%), and meropenem (56%) were observed in S. pneumoniae. Frequent mutations at STMK and SRNVP motifs in PBP1a (41%), SSNT motif in PBP2b (32%), and STMK and LKSG motifs in PBP2x (41%) were observed in S. pneumoniae. H. influenzae remained highly susceptible to most β-lactams, except for ampicillin. Approximately half of the ampicillin non-susceptible H. influenzae harboured PBP3 mutations (56%) and only blaTEM was detected in the ampicillin-resistant strains (47%). Methicillin-susceptible S. aureus (MSSA) strains were mostly resistant to penicillin G (92%), with at least two-fold higher median minimum inhibitory concentrations (MIC) for all penicillin antibiotics (except ticarcillin) compared to S. pneumoniae and H. influenzae. Almost all URTI strains (88–100%) were susceptible to cefcapene and flomoxef. Overall, β-lactam antibiotics except penicillins remained largely effective against URTI pathogens in this region.

High Prevalence and Varied Distribution of Antibiotic-Resistant Bacteria in the Rhizosphere and Rhizoplane of Citrus medica

“…β-lactam class antibiotics contain a β-lactam ring in their chemical structure and are the most widely used antibiotics at present [31,32]. In recent years, β-lactam-resistant pathogens have become a serious threat in clinical settings [33]. Notably, the opportunistic pathogens identified in our study, including M. luteus, A. radiobacter, and Brevundimonas spp., were all resistant to at least one of the three tested β-lactam class antibiotics.…”

Antibacterial therapy: questions posed by COVID-19 and real clinical practice

“…В то же время H. influenzae оставалась высокочувствительной к большинству β-лактамов, за исключением ампициллина. В целом β-лактамные антибиотики, за исключением пенициллинов, оставались в значительной степени эффективными против возбудителей, высеянных от пациентов с ОРВИ в этом регионе [36]. Грамотрицательные бактерии являются частыми возбудителями легочной инфекции у пациентов пожилого возраста.…”

MALDI-TOF MS Indirect Beta-Lactamase Detection in Ampicillin-Resistant Haemophilus influenzae

“…Prompt antibiotic treatment is key in the management of infection caused by H. influenzae. β-lactam antibiotics such as ampicillin are commonly used to treat infections caused by H. influenzae, but resistant isolates often occur [3]. For example, the number of isolates resistant to ampicillin increased from 8.6% in 2010 to 22.1% in 2019 in the Czech Republic [4], from 14.9% (2007)(2008)(2009) to 24% (2013) in Italy [5][6][7], to 57.6% in Asia, 70.4-73.3% in North America and the Middle East, 80.7-86.1% in Europe, Latin America and Africa and from 13.5% (2007-2010) to 19% (2011-2014) in Canada [8].…”