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

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dc.contributor.authorPerovic, O
dc.contributor.authorSingh-Moodley, A
dc.contributor.authorDuse, A
dc.contributor.authorBamford, C
dc.contributor.authorElliott, G
dc.contributor.authorSwe Swe-Han, K
dc.contributor.authorKularatne, R
dc.contributor.authorLowman, W
dc.contributor.authorWhitelaw, A
dc.contributor.authorNana, T
dc.contributor.authorWadula, J
dc.contributor.authorLekalakala, Ruth
dc.contributor.authorSaif, A
dc.contributor.authorDe-Smidt, M F
dc.contributor.authorMarais, A
dc.date.accessioned2016-08-17T11:21:06Z
dc.date.available2016-08-17T11:21:06Z
dc.date.issued2014
dc.date.updated2016-03-22T12:28:07Z
dc.description.abstractBACKROUND: 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., Duse, A., Bamford, C., Elliott, G., Swe Swe-Han, K., ... Marais, A. (2014). National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumonia isolates in South Africa 2010-2012. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/21302en_ZA
dc.identifier.chicagocitationPerovic, O, A Singh-Moodley, A Duse, C Bamford, G Elliott, K Swe Swe-Han, R Kularatne, et al "National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumonia isolates in South Africa 2010-2012." <i>South African Medical Journal</i> (2014) http://hdl.handle.net/11427/21302en_ZA
dc.identifier.citationPerovic, O., Singh-Moodley, A., Dusé, A., Bamford, C., Elliott, G., Swe Swe-Han, K., ... & Wadula, J. (2014). National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumoniae isolates in South Africa, 2010-2012. SAMJ: South African Medical Journal, 104(8), 563-568.
dc.identifier.issn0256-9574
dc.identifier.ris TY - Journal Article AU - Perovic, O AU - Singh-Moodley, A AU - Duse, A AU - Bamford, C AU - Elliott, G AU - Swe Swe-Han, K AU - Kularatne, R AU - Lowman, W AU - Whitelaw, A AU - Nana, T AU - Wadula, J AU - Lekalakala, Ruth AU - Saif, A AU - De-Smidt, M F AU - Marais, A AB - 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 J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 SM - 0256-9574 T1 - National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumonia isolates in South Africa 2010-2012 TI - National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumonia isolates in South Africa 2010-2012 UR - http://hdl.handle.net/11427/21302 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/21302
dc.identifier.vancouvercitationPerovic O, Singh-Moodley A, Duse A, Bamford C, Elliott G, Swe Swe-Han K, et al. National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumonia isolates in South Africa 2010-2012. South African Medical Journal. 2014; http://hdl.handle.net/11427/21302.en_ZA
dc.language.isoeng
dc.publisherHealth and Medical Publishing Group
dc.publisher.departmentDepartment of Clinical Laboratory Sciencesen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceSouth African Medical Journal
dc.source.urihttp://www.samj.org.za
dc.titleNational sentinel site surveillance for antimicrobial resistance in Klebsiella pneumonia isolates in South Africa 2010-2012
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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