Archive for April 5, 2016

Antibiotic susceptibility in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in Pakistan: a review of results from the Survey of Antibiotic Resistance (SOAR) 2002–15

Journal of Antimicrobial Chemotherapy May 2016 V.71 Suppl 1 i103-i109

Zafar, R. Hasan, S. Nizamuddin, N. Mahmood, S. Mukhtar, F. Ali, I. Morrissey, K. Barker, and D. Torumkuney

1Aga Khan University Hospital, Department of Pathology and Laboratory Medicine, Section of Microbiology, Karachi, Pakistan

2Shaukat Khanum Memorial Cancer Hospital and Research Center, Department of Microbiology, 7A, Block R-3, Johar Town, Lahore, Pakistan

3GlaxoSmithKline Pakistan, 35 Dockyard Road, West Wharf, Karachi 74000, Pakistan

4IHMA Europe Sàrl, 9a route de la Corniche, Epalinges 1066, Switzerland

5GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK

Objectives

To investigate changes in the antibiotic susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes from the Survey of Antibiotic Resistance (SOAR) in community-acquired respiratory tract infections (CA-RTIs) between 2002 and 2015 in Pakistan.

Methods

This is a review based on previously published studies from 2002–03, 2004–06 and 2007–09 and also new data from 2014–15. Susceptibility was determined by Etest® or disc diffusion according to CLSI and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.

Results

A total of 706 isolates from CA-RTIs comprising 381 S. pneumoniae, 230 H. influenzae and 95 S. pyogenes were collected between 2002 and 2015 and tested against a range of antibiotics. Antibiotic resistance in S. pneumoniae rose steeply from 2002 to 2009, with isolates non-susceptible to penicillin and macrolides increasing from 10% to 34.1% and from 13%–14% to 29.7%, respectively. Susceptibility to amoxicillin/clavulanic acid (and by inference amoxicillin) remained between 99.4% and 100% from 2002 to 2015. Over the years, the prevalence of susceptibility to cefuroxime was 98%–100% among S. pneumoniae. Resistance in S. pneumoniae to some older antibiotics between 2007 and 2009 was high (86.8% for trimethoprim/sulfamethoxazole and 57.2% for tetracycline). Between 2002 and 2015, ampicillin resistance (β-lactamase-positive strains) among H. influenzae has remained low (between 2.6% and 3.2%) and almost unchanged over the years (H. influenzae was not tested during 2004–06). For S. pyogenes isolates, macrolide resistance reached 22%; however, susceptibility to penicillin, amoxicillin/clavulanic acid and cefuroxime remained stable at 100%.

Conclusions

In S. pneumoniae from Pakistan, there has been a clear reduction in susceptibility to key antibiotics since 2002, but not to amoxicillin/clavulanic acid (amoxicillin) or cefuroxime. However, susceptibility in H. influenzae has remained stable. Local antibiotic susceptibility/resistance data are essential to support informed prescribing for CA-RTIs and other infections.

PDF

http://jac.oxfordjournals.org/content/71/suppl_1/i103.full.pdf

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April 5, 2016 at 7:57 pm

Results from the Survey of Antibiotic Resistance (SOAR) 2009–11 and 2013–14 in China

Journal of Antimicrobial Chemotherapy May 2016 V.71 Suppl 1 i33-i43

Hu, D. Zhu, F. Wang, I. Morrissey, J. Wang, and D. Torumkuney

1Institute of Antibiotics, Huashan Hospital, Fudan University, Building No. 6, 12 Middle Urumqi Road, Shanghai, China

2Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Building No. 6, 12 Middle Urumqi Road, Shanghai, China

3IHMA Europe Sàrl, 9A route de la Corniche, Epalinges 1066, Switzerland

4GlaxoSmithKline, The Headquarters Building, No. 168 Middle Tibet Road, Shanghai 200001, China

5GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK

Objectives

To compare antibiotic susceptibility of community-acquired respiratory bacteria in China during 2009–11 and 2013–14.

Methods

Susceptibility was determined by Etest® (bioMérieux) or disc diffusion according to CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints, except for azithromycin where Etest® breakpoints (in CO2 incubation) were used in place of standard CLSI breakpoints. Statistical significance of differences in susceptibility across time periods was evaluated using Fisher’s exact test.

Results

During 2009–11, 434 Streptococcus pneumoniae, 307 Haemophilus influenzae and 140 Moraxella catarrhalis were collected from eight centres and during 2013–14, 208 S. pneumoniae, 185 H. influenzae and 80 M. catarrhalis were collected from five centres. Penicillin-non-susceptible isolates remained stable at ∼66% over both time periods but susceptibility decreased significantly for amoxicillin/clavulanic acid (or amoxicillin) and cefaclor. For H. influenzae, the proportion of β-lactamase-positive isolates and β-lactamase-negative ampicillin-resistant strains (CLSI definition) was higher in 2013–14 (25.4% and 7.0%, respectively) than in 2009–11 (16.3% and 3.6%, respectively), with decreased ampicillin and cephalosporin susceptibility. By 2009–11 and 2013–14, only amoxicillin/clavulanic acid (amoxicillin), levofloxacin, penicillin (intravenously) and chloramphenicol inhibited >70% of S. pneumoniae. During 2013–14, M. catarrhalis showed increasing resistance, with cefaclor and levofloxacin susceptibility decreasing significantly. However, amoxicillin/clavulanic acid, cefuroxime and levofloxacin continued to inhibit >90% of isolates.

Conclusions

On the whole, antimicrobial susceptibility decreased in China between 2009–11 and 2013–14. In 2013–14, amoxicillin/clavulanic acid, levofloxacin and chloramphenicol were the most active antibacterial agents tested against community-acquired respiratory pathogens when assessed by CLSI, EUCAST or PK/PD breakpoints. Resistance to other antibacterials in China was generally high. Our data demonstrate the need to harmonize breakpoints for these pathogens.

PDF

http://jac.oxfordjournals.org/content/71/suppl_1/i33.full.pdf

 

April 5, 2016 at 7:55 pm

Results from the Survey of Antibiotic Resistance (SOAR) 2011–14 in the Democratic Republic of Congo, Ivory Coast, Republic of Senegal and Kenya

Journal of Antimicrobial Chemotherapy May 2016 V.71 Suppl 1  i21-i31

Kacou-Ndouba, G. Revathi, P. Mwathi, A. Seck, A. Diop, M. J. Kabedi-Bajani, W. Mwiti, M. J. Anguibi-Pokou, I. Morrissey, and D. Torumkuney

1Institute Pasteur, 01 BP 490 Abidjan 01, Côte d’Ivoire

2Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya, PO Box 30270, 00100

3Kenyatta National Hospital, Microbiology Department, P.O. Box 20723, Nairobi, Kenya 00200

4Institute Pasteur Dakar, Dakar Faculty of Medicine, 36 Avenue Pasteur, B.P. 220, Dakar, Senegal

5University of Dakar, Faculty of Medicine, BP 45515, Dakar-Fann, Senegal

6University of Kinshasa, National Institute Biomedical Research (INRB), Kinshasa, Democratic Republic of Congo

7GlaxoSmithKline Kenya, 23 Likoni Road, P.O. Box 78392, Nairobi, Kenya 00507

8GlaxoSmithKline West and Central Africa, 7 Rue des Bougainvilliers Cocody, 01 BP 8111 Abidjan 01, Cote d’Ivoire

9IHMA Europe Sàrl, 9A route de la Corniche, Epalinges 1066, Switzerland

10GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK

Objectives

To assess antibiotic susceptibility of community-acquired respiratory tract isolates from Ivory Coast, Kenya, Democratic Republic of Congo (DRC) and Senegal in 2011–14.

Methods

Bacterial isolates were collected and MICs determined using Etest® for all antibiotics except erythromycin, for which testing was by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. For macrolide interpretation, CLSI breakpoints were adjusted for incubation in CO2.

Results

Susceptibility to penicillin (using CLSI oral or EUCAST breakpoints) was low among isolates of Streptococcus pneumoniae from the DRC and Kenya (17.4% and 19%, respectively) but higher among isolates from the Ivory Coast (70%) and Senegal (85.7%). Penicillin susceptibility using CLSI iv breakpoints was higher in all countries, but still only 69.6% in the DRC. Macrolide susceptibility (based on CLSI erythromycin disc diffusion breakpoints) was also low in Kenya (65%) but 87%–100% elsewhere. Haemophilus influenzae were only collected in the DRC and Senegal, with β-lactamase prevalence of 39% and 4%, respectively. Furthermore, β-lactamase-negative ampicillin-resistant (BLNAR) isolates were found in DRC (four isolates, 17%), but only two isolates were found in Senegal (by EUCAST definition). Amoxicillin/clavulanic acid in vitro susceptibility was 73.9% in the DRC and 100% in Senegal based on CLSI breakpoints, but this reduced to 65.2% in the DRC when BLNAR rates were considered. Clarithromycin susceptibility was >95% in both countries.

Conclusions

There was considerable variability in antibiotic susceptibility among the African countries participating in the surveillance programme. Thus, continued surveillance is necessary to track future changes in antibiotic resistance. Use of EUCAST versus CLSI breakpoints showed profound differences for cefaclor and ofloxacin against S. pneumoniae, with EUCAST showing lower susceptibility.

PDF

http://jac.oxfordjournals.org/content/71/suppl_1/i21.full.pdf

April 5, 2016 at 7:54 pm

Results from the Survey of Antibiotic Resistance (SOAR) 2012–14 in Thailand, India, South Korea and Singapore

Journal of Antimicrobial Chemotherapy May 2016 V.71 Suppl 1 i3-i19

Torumkuney, R. Chaiwarith, W. Reechaipichitkul, K. Malatham, V. Chareonphaibul, C. Rodrigues, D. S. Chitins, M. Dias, S. Anandan, S. Kanakapura, Y. J. Park, K. Lee, H. Lee, J. Y. Kim, Y. Lee, H. K. Lee, J. H. Kim, T. Y. Tan, Y. X. Heng, P. Mukherjee, and I. Morrissey

1GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK

2Faculty of Medicine, Chiang Mai University, Maharaj Nakorn Chiang Mai Hospital, 110 Intavaroros Road, Tambon Sribhoom, Muang, Chiang Mai 50200, Thailand

3Khon Kaen University Faculty of Medicine, Srinagarind Hospital, 123 Mittraphap Highway, Tambol Naimuang, Muang District, Khon Kaen 40002, Thailand

4Mahidol University Faculty of Medicine Ramathibodi Hospital, 270 Rama VI. Road, oong Phayathai, Ratchathewi, Bangkok 10400, Thailand

5GlaxoSmithKline Thailand, 12th Floor, Wave Place, 55 Wireless Road, Lumpini, Patumwan, Bangkok 10330, Thailand

6Hinduja Hospital and Medical Research Centre, Department of Microbiology, Veer Savarkar Marg, Mahim, Mumbai 400 016, India

7Choithram Hospital and Research Centre, Department of Microbiology, Manik Bagh Road, Indore 452 014 (M/P), India

8St John’s Medical College Hospital, Department of Microbiology, Sarjapur Road, Bangalore 560 034, India

9Christian Medical College, Department of Microbiology, Vellore 632 004, India

10GlaxoSmithKline India, No. 5 Embassy Links, Cunningham (SRT) Road, Bangalore 560 052, India

11The Catholic University of Korea, Seoul St Mary’s Hospital, 222 Banpo-daero, Seocho-Gu, Seoul, South Korea

12Yonsei University College of Medicine, Severance Hospital, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea

13Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea

14Hanyang University Medical Center, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, South Korea

15The Catholic University of Korea, Uijongbu St Mary’s Hospital, 271, Cheonbo-ro, Ukjeongbu-si, Gyeonggi-do, Korea

16GlaxoSmithKline Korea, LS Yongsan Tower, 9th Floor, Hangang 191, Yongsan-gu, Seoul, South Korea

17Changi General Hospital Pte Ltd (Reg. No. 198904226R), 2 Simei Street 3, Singapore 529889

18GlaxoSmithKline Singapore, (Reg. No. 198102938K), 150 Beach Road, No. 22-00 Gateway West, Singapore 189720

19IHMA Europe Sàrl, 9A Route de la Corniche, Epalinges 1066, Switzerland

Objectives

To provide susceptibility data for community-acquired respiratory tract isolates of Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae and Moraxella catarrhalis collected in 2012–14 from four Asian countries.

Methods

MICs were determined using Etest® for all antibiotics except erythromycin, which was evaluated by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. For macrolide/clindamycin interpretation, breakpoints were adjusted for incubation in CO2 where available.

Results

Susceptibility of S. pneumoniae was generally lower in South Korea than in other countries. Penicillin susceptibility assessed using CLSI oral or EUCAST breakpoints ranged from 21.2% in South Korea to 63.8% in Singapore. In contrast, susceptibility using CLSI intravenous breakpoints was much higher, at 79% in South Korea and 95% or higher elsewhere. Macrolide susceptibility was 20% in South Korea and 50%–60% elsewhere. Among S. pyogenes isolates (India only), erythromycin susceptibility (20%) was lowest of the antibiotics tested. In H. influenzae antibiotic susceptibility was high except for ampicillin, where susceptibility ranged from 16.7% in South Korea to 91.1% in India. South Korea also had a high percentage (18.1%) of β-lactamase-negative ampicillin-resistant isolates. Amoxicillin/clavulanic acid susceptibility for each pathogen (PK/PD high dose) was between 93% and 100% in all countries except for H. influenzae in South Korea (62.5%).

Conclusions

Use of EUCAST versus CLSI breakpoints had profound differences for cefaclor, cefuroxime and ofloxacin, with EUCAST showing lower susceptibility. There was considerable variability in susceptibility among countries in the same region. Thus, continued surveillance is necessary to track future changes in antibiotic resistance.

PDF

http://jac.oxfordjournals.org/content/71/suppl_1/i3.full.pdf

April 5, 2016 at 7:52 pm


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