Emergence of High Levels of Extended-Spectrum-Beta-Lactamase-Producing Gram-Negative Bacilli in the Asia-Pacific Region: Data from the Study for Monitoring Antimicrobial Resistance Trends (Smart) Program, 2007

Abstract

Of 3,004 gram-negative bacilli collected from intra- abdominal infections in the Asia-Pacific region during 2007, 42.2% and 35.8% of Escherichia coli and Klebsiella spp., respectively, were extended-spectrum beta- lactamase (ESBL) positive. Moreover ESBL rates in India for E. coli, Klebsiella pneumoniae, and Klebsiella oxytoca were 79.0%, 69 .4%, and 100% , respectively. ESBL-positive E. coli rates were also relatively high in China (55.0%) and Thailand (50. 8%). Ertapenem and imipenem were the most active drugs tested, inhibiting over 90% of all species, including ESBL- positive isolates with the exception of Pseudomonas aeruginosa isolates (< 90% susceptible to all study drugs) and ESBL-positive Klebsiella pneumoniae isolates (<90% susceptible to all study drugs except imipenem). Quinolones achieved 90% inhibition levels only against ESBL-negative K. pneumoniae and ESBL-negative K. oxytoca. A decline in ampicillin-sulbactam activity was noted, with only 34.5% of all Enterobacteriaceae inhibited in this study.