Yap, Polly Soo Xi and Chong, Chun Wie and Ponnampalavanar, Sasheela and Ramli, Ramliza and Harun, Azian and Jamaluddin, Tengku Zetty Maztura Tengku and Khan, Anis Ahmed and Ngoi, Soo Tein and Lee, Yee Qing and Lau, Min Yi and Tan, Shiang Chiet and Kong, Zhi Xian and Woon, Jia Jie and Mak, Siew Thong and Jabar, Kartini Abdul and Karunakaran, Rina and Ismail, Zalina and Salleh, Sharifah Azura and Noor, Siti Suraiya Md and Masri, Siti Norbaya and Taib, Niazlin Mohd and Jasni, Azmiza Syawani and Tee, Loong Hua and Leong, Kin Chong and Lim, Victor Kok Eow and Abu Bakar, Sazaly and Teh, Cindy Shuan Ju (2023) A multicentre study to determine the in vitro efficacy of flomoxef against extended-spectrum beta-lactamase producing Escherichia coli in Malaysia. PeerJ, 11. ISSN 2167-8359, DOI https://doi.org/10.7717/peerj.16393.
Full text not available from this repository.Abstract
Background: The high burden of extended-spectrum beta-lactamase-producing (ESBL)-producing Enterobacterales worldwide, especially in the densely populated South East Asia poses a significant threat to the global transmission of antibiotic resistance. Molecular surveillance of ESBL-producing pathogens in this region is vital for understanding the local epidemiology, informing treatment choices, and addressing the regional and global implications of antibiotic resistance. Methods: Therefore, an inventory surveillance of the ESBL-Escherichia coli (ESBL-EC) isolates responsible for infections in Malaysian hospitals was conducted. Additionally, the in vitro efficacy of flomoxef and other established antibiotics against ESBL-EC was evaluated. Results: A total of 127 non-repetitive ESBL-EC strains isolated from clinical samples were collected during a multicentre study performed in five representative Malaysian hospitals. Of all the isolates, 33.9% were isolated from surgical site infections and 85.8% were hospital-acquired infections. High rates of resistance to cefotaxime (100%), cefepime (100%), aztreonam (100%) and trimethoprim-sulfamethoxazole (100%) were observed based on the broth microdilution test. Carbapenems remained the most effective antibiotics against the ESBL-EC, followed by flomoxef. Antibiotic resistance genes were identified by PCR. The blaCTX-M-1 was the most prevalent ESBL gene, with 28 isolates (22%) harbouring blaCTX-M-1 only, 27 isolates (21.3%) co-harbouring blaCTX-M-1 and blaTEM, and ten isolates (7.9%) co-harbouring blaCTX-M-1, blaTEM and blaSHV. A generalised linear model showed significant antibacterial activity of imipenem against different types of infection. Besides carbapenems, this study also demonstrated a satisfactory antibacterial activity of flomoxef (81.9%) on ESBL-EC, regardless of the types of ESBL genes.
| Item Type: | Article |
|---|---|
| Funders: | Ministry of Education, Malaysia [Grant no. TRGS/1/2020/UM/02/2/2], Shionogi Singapore Pte. Ltd. [Grant no. IF015-2018] |
| Uncontrolled Keywords: | Extended-spectrum beta-lactamase (ESBL); Escherichia coli; Antimicrobial resistance; Flomoxef; Enterobacterales; Surgical site infection |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine > Anaesthesiology Department Faculty of Medicine > Medical Microbiology Department Faculty of Medicine > Medicine Department Deputy Vice Chancellor (Research & Innovation) Office > Tropical Infectious Diseases Research and Education Centre |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 20 Oct 2025 13:57 |
| Last Modified: | 20 Oct 2025 13:57 |
| URI: | http://eprints.um.edu.my/id/eprint/48082 |
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