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Prevalence and genotypic relatedness of carbapenem resistance among multidrug-resistant P. aeruginosa in tertiary hospitals across Thailand.

Khuntayaporn P, Montakantikul P, Mootsikapun P, Thamlikitkul V, Chomnawang MT - Ann. Clin. Microbiol. Antimicrob. (2012)

Bottom Line: About 261 clinical isolates were identified as MDR P. aeruginosa and approximately 71.65% were found to be CR-MDR P. aeruginosa.Although the antibiotic resistance rate was high, the spreading of CR-MDR was found locally.Specific strains of CR-MDR did not commonly spread from one hospital to another.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Microbiology, Faculty of Pharmacy, Mahidol University, 447 Sri Ayudthaya Road, Rachathevi, Bangkok, 10400, Thailand.

ABSTRACT

Background: Increased infection caused by multidrug resistant (MDR) Pseudomonas aeruginosa has raised awareness of the resistance situation worldwide. Carbapenem resistance among MDR (CR-MDR) P. aeruginosa has become a serious life-threatening problem due to the limited therapeutic options. Therefore, the objectives of this study were to determine the prevalence, the antibiotic susceptibility patterns and the relatedness of CR-MDR P. aeruginosa in tertiary hospitals across Thailand.

Methods: MDR P. aeruginosa from eight tertiary hospitals across Thailand were collected from 2007-2009. Susceptibility of P. aeruginosa clinical isolates was determined according to the Clinical and Laboratory Standards Institute guideline. Selected CR-MDR P. aeruginosa isolates were genetically analyzed by pulsed-field gel electrophoresis.

Results: About 261 clinical isolates were identified as MDR P. aeruginosa and approximately 71.65% were found to be CR-MDR P. aeruginosa. The result showed that the meropenem resistance rate was the highest reaching over 50% in every hospitals. Additionally, the type of hospitals was a major factor affecting the resistance rate, as demonstrated by significantly higher CR-MDR rates among university and regional hospitals. The fingerprinting map identified 107 clones with at least 95% similarity. Only 4 clones were detected in more than one hospital.

Conclusions: Although the antibiotic resistance rate was high, the spreading of CR-MDR was found locally. Specific strains of CR-MDR did not commonly spread from one hospital to another. Importantly, clonal dissemination ratio indicated limited intra-hospital transmission in Thailand.

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Related in: MedlinePlus

A fingerprinting map showing the percentage of similarity among 187 strains of CR-MDR P. aeruginosa.
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Figure 1: A fingerprinting map showing the percentage of similarity among 187 strains of CR-MDR P. aeruginosa.

Mentions: One-hundred and eighty-seven strains of CR-MDR P. aeruginosa were analyzed by pulsed-field gel electrophoresis and 107 clones were identified as having 95% similarity (Figure 1). Only 4 clones from 107 clones were detected in more than one hospital (Table 2). Two clones isolated from hospitals of the same region were found to be related. Another clone was found related in hospitals from two separate regions. The last clone was found in three hospitals that were located in three separated regions. Furthermore, the clonal dissemination ratio of higher than 2.0 was found in two hospitals in which the isolates were highly dominated at about 9 isolates per clone. (Table 2)


Prevalence and genotypic relatedness of carbapenem resistance among multidrug-resistant P. aeruginosa in tertiary hospitals across Thailand.

Khuntayaporn P, Montakantikul P, Mootsikapun P, Thamlikitkul V, Chomnawang MT - Ann. Clin. Microbiol. Antimicrob. (2012)

A fingerprinting map showing the percentage of similarity among 187 strains of CR-MDR P. aeruginosa.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475077&req=5

Figure 1: A fingerprinting map showing the percentage of similarity among 187 strains of CR-MDR P. aeruginosa.
Mentions: One-hundred and eighty-seven strains of CR-MDR P. aeruginosa were analyzed by pulsed-field gel electrophoresis and 107 clones were identified as having 95% similarity (Figure 1). Only 4 clones from 107 clones were detected in more than one hospital (Table 2). Two clones isolated from hospitals of the same region were found to be related. Another clone was found related in hospitals from two separate regions. The last clone was found in three hospitals that were located in three separated regions. Furthermore, the clonal dissemination ratio of higher than 2.0 was found in two hospitals in which the isolates were highly dominated at about 9 isolates per clone. (Table 2)

Bottom Line: About 261 clinical isolates were identified as MDR P. aeruginosa and approximately 71.65% were found to be CR-MDR P. aeruginosa.Although the antibiotic resistance rate was high, the spreading of CR-MDR was found locally.Specific strains of CR-MDR did not commonly spread from one hospital to another.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Microbiology, Faculty of Pharmacy, Mahidol University, 447 Sri Ayudthaya Road, Rachathevi, Bangkok, 10400, Thailand.

ABSTRACT

Background: Increased infection caused by multidrug resistant (MDR) Pseudomonas aeruginosa has raised awareness of the resistance situation worldwide. Carbapenem resistance among MDR (CR-MDR) P. aeruginosa has become a serious life-threatening problem due to the limited therapeutic options. Therefore, the objectives of this study were to determine the prevalence, the antibiotic susceptibility patterns and the relatedness of CR-MDR P. aeruginosa in tertiary hospitals across Thailand.

Methods: MDR P. aeruginosa from eight tertiary hospitals across Thailand were collected from 2007-2009. Susceptibility of P. aeruginosa clinical isolates was determined according to the Clinical and Laboratory Standards Institute guideline. Selected CR-MDR P. aeruginosa isolates were genetically analyzed by pulsed-field gel electrophoresis.

Results: About 261 clinical isolates were identified as MDR P. aeruginosa and approximately 71.65% were found to be CR-MDR P. aeruginosa. The result showed that the meropenem resistance rate was the highest reaching over 50% in every hospitals. Additionally, the type of hospitals was a major factor affecting the resistance rate, as demonstrated by significantly higher CR-MDR rates among university and regional hospitals. The fingerprinting map identified 107 clones with at least 95% similarity. Only 4 clones were detected in more than one hospital.

Conclusions: Although the antibiotic resistance rate was high, the spreading of CR-MDR was found locally. Specific strains of CR-MDR did not commonly spread from one hospital to another. Importantly, clonal dissemination ratio indicated limited intra-hospital transmission in Thailand.

Show MeSH
Related in: MedlinePlus