National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumoniae isolates in South Africa, 2010 - 2012

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dc.contributor.authorPerovic, Olga
dc.contributor.authorSingh-Moodley, Ashika
dc.contributor.authorDusé, Adriano
dc.contributor.authorBamford, Colleen
dc.contributor.authorElliott, G
dc.contributor.authorSwe-Han, Khine Swe
dc.contributor.authorKularatne, Ranmini
dc.contributor.authorLowman, Warren
dc.contributor.authorWhitelaw, Andrew
dc.contributor.authorNana, Trusha
dc.contributor.authorWadula, Jeanette
dc.contributor.authorLekalakala, Ruth
dc.contributor.authorSaif, Adrienne
dc.contributor.authorFortuin-de Smit, Melony
dc.contributor.authorMarais, Else
dc.date.accessioned2021-10-08T07:20:28Z
dc.date.available2021-10-08T07:20:28Z
dc.date.issued2014
dc.description.abstractABSTRACT BACKROUND: The increasing rates of antimicrobial resistance observed in the nosocomial pathogen Klebsiella pneumoniae are of major public health concern worldwide. OBJECTIVES: To describe the antibiotic susceptibility profiles of K. pneumoniae isolates from bacteraemic patients submitted by sentinel laboratories in five regions of South Africa from mid-2010 to mid-2012. Molecular methods were used to detect the most commonly found extended-spectrum beta-lactamase (ESBL) and carbapenemase resistance genes. METHODS: Thirteen academic centres serving the public healthcare sector in Gauteng, KwaZulu-Natal, Free State, Limpopo and Western Cape provinces submitted K. pneumoniae isolates from patients with bloodstream infections. Vitek 2 and MicroScan instruments were used for organism identification and susceptibility testing. Multiplex polymerase chain reactions (PCRs) were used to detect blaCTX-M, blaSHV and blaTEM genes in a proportion of the ESBL isolates. All isolates exhibiting reduced susceptibility to carbapenems were PCR tested for blaKPC and blaNDM-1 resistance genes. RESULTS: Overall, 68.3% of the 2 774 isolates were ESBL-positive, showing resistance to cefotaxime, ceftazidime and cefepime. Furthermore, 46.5% of all isolates were resistant to ciprofloxacin and 33.1% to piperacillin-tazobactam. The major ESBL genes were abundantly present in the sample analysed. Most isolates (95.5%) were susceptible to the carbapenems tested, and no isolates were positive for blaKPC or blaNDM1 There was a trend towards a decrease in susceptibility to most antibiotics. CONCLUSION: The high proportion of ESBL-producing K. pneumoniae isolates observed, and the prevalence of ESBL genes, are of great concern. Our findings represent a baseline for further surveillance in SA, and can be used for policy and treatment decisions.
dc.identifier.apacitationPerovic, O., Singh-Moodley, A., Dusé, A., Bamford, C., Elliott, G., Swe-Han, K. S., ... Marais, E. (2014). National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumoniae isolates in South Africa, 2010 - 2012. <i>South African Medical Journal</i>, 104(8), 563 - 177. http://hdl.handle.net/11427/34925en_ZA
dc.identifier.chicagocitationPerovic, Olga, Ashika Singh-Moodley, Adriano Dusé, Colleen Bamford, G Elliott, Khine Swe Swe-Han, Ranmini Kularatne, et al "National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumoniae isolates in South Africa, 2010 - 2012." <i>South African Medical Journal</i> 104, 8. (2014): 563 - 177. http://hdl.handle.net/11427/34925en_ZA
dc.identifier.citationPerovic, O., Singh-Moodley, A., Dusé, A., Bamford, C., Elliott, G., Swe-Han, K.S., Kularatne, R. & Lowman, W. et al. 2014. National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumoniae isolates in South Africa, 2010 - 2012. <i>South African Medical Journal.</i> 104(8):563 - 177. http://hdl.handle.net/11427/34925en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Perovic, Olga AU - Singh-Moodley, Ashika AU - Dusé, Adriano AU - Bamford, Colleen AU - Elliott, G AU - Swe-Han, Khine Swe AU - Kularatne, Ranmini AU - Lowman, Warren AU - Whitelaw, Andrew AU - Nana, Trusha AU - Wadula, Jeanette AU - Lekalakala, Ruth AU - Saif, Adrienne AU - Fortuin-de Smit, Melony AU - Marais, Else AB - ABSTRACT BACKROUND: The increasing rates of antimicrobial resistance observed in the nosocomial pathogen Klebsiella pneumoniae are of major public health concern worldwide. OBJECTIVES: To describe the antibiotic susceptibility profiles of K. pneumoniae isolates from bacteraemic patients submitted by sentinel laboratories in five regions of South Africa from mid-2010 to mid-2012. Molecular methods were used to detect the most commonly found extended-spectrum beta-lactamase (ESBL) and carbapenemase resistance genes. METHODS: Thirteen academic centres serving the public healthcare sector in Gauteng, KwaZulu-Natal, Free State, Limpopo and Western Cape provinces submitted K. pneumoniae isolates from patients with bloodstream infections. Vitek 2 and MicroScan instruments were used for organism identification and susceptibility testing. Multiplex polymerase chain reactions (PCRs) were used to detect blaCTX-M, blaSHV and blaTEM genes in a proportion of the ESBL isolates. All isolates exhibiting reduced susceptibility to carbapenems were PCR tested for blaKPC and blaNDM-1 resistance genes. RESULTS: Overall, 68.3% of the 2 774 isolates were ESBL-positive, showing resistance to cefotaxime, ceftazidime and cefepime. Furthermore, 46.5% of all isolates were resistant to ciprofloxacin and 33.1% to piperacillin-tazobactam. The major ESBL genes were abundantly present in the sample analysed. Most isolates (95.5%) were susceptible to the carbapenems tested, and no isolates were positive for blaKPC or blaNDM1 There was a trend towards a decrease in susceptibility to most antibiotics. CONCLUSION: The high proportion of ESBL-producing K. pneumoniae isolates observed, and the prevalence of ESBL genes, are of great concern. Our findings represent a baseline for further surveillance in SA, and can be used for policy and treatment decisions. DA - 2014 DB - OpenUCT DP - University of Cape Town IS - 8 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2014 SM - 0038-2469 T1 - National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumoniae isolates in South Africa, 2010 - 2012 TI - National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumoniae isolates in South Africa, 2010 - 2012 UR - http://hdl.handle.net/11427/34925 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34925
dc.identifier.vancouvercitationPerovic O, Singh-Moodley A, Dusé A, Bamford C, Elliott G, Swe-Han KS, et al. National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumoniae isolates in South Africa, 2010 - 2012. South African Medical Journal. 2014;104(8):563 - 177. http://hdl.handle.net/11427/34925.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Clinical Laboratory Sciences
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue8
dc.source.journalvolume104
dc.source.pagination563 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.7617
dc.subject.otherInfection
dc.subject.otherbeta-Lactamases
dc.subject.otherCarbapenems
dc.subject.otherCeftazidime
dc.subject.otherCiprofloxacin
dc.subject.otherCefotaxime
dc.subject.otherPiperacillin
dc.subject.otherGenes
dc.subject.otherMultiplex Polymerase Chain Reaction
dc.subject.otherTherapeutics
dc.subject.otherSentinel Surveillance
dc.subject.otherPrevalence
dc.subject.otherKlebsiella pneumoniae
dc.subject.otherSurveillance
dc.subject.otherNosocomial
dc.subject.otherSouth Africa
dc.subject.otherKlebsiella pneumoniae
dc.subject.otherExtended-spectrum beta-lactamases
dc.titleNational sentinel site surveillance for antimicrobial resistance in Klebsiella pneumoniae isolates in South Africa, 2010 - 2012
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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