Ngoi, Soo Tein and Chong, Chun Wie and Ponnampalavanar, Sasheela Sri La Sri and Tang, Soo Nee and Idris, Nuryana and Abdul Jabar, Kartini and Gregory, Michael J. and Husain, Tupur and Teh, Cindy Shuan Ju (2021) Genetic mechanisms and correlated risk factors of antimicrobial-resistant ESKAPEE pathogens isolated in a tertiary hospital in Malaysia. Antimicrobial Resistance And Infection Control, 10 (1). ISSN 2047-2994, DOI https://doi.org/10.1186/s13756-021-00936-5.
Full text not available from this repository.Abstract
Background Knowledge on the epidemiology, genotypic and phenotypic features of antimicrobial-resistant (AMR) ESKAPEE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp., and Escherichia coli) and their association with hospital-acquired infections (HAIs) are limited in Malaysia. Therefore, we evaluated the AMR features and resistance mechanisms of the ESKAPEE pathogens collected in a tertiary hospital located in the capital of Malaysia. Methods A total of 378 AMR-ESKAPEE strains were obtained based on convenience sampling over a nine-month study period (2019-2020). All strains were subjected to disk diffusion and broth microdilution assays to determine the antimicrobial susceptibility profiles. Polymerase chain reaction (PCR) and DNA sequence analyses were performed to determine the AMR genes profiles of the non-susceptible strains. Chi-square test and logistic regression analyses were used to correlate the AMR profiles and clinical data to determine the risk factors associated with HAIs. Results High rates of multidrug resistance (MDR) were observed in A. baumannii, K. pneumoniae, E. coli, and S. aureus (69-89%). All organisms except E. coli were frequently associated with HAIs (61-94%). Non-susceptibility to the last-resort drugs vancomycin (in Enterococcus spp. and S. aureus), carbapenems (in A. baumannii, P. aeruginosa, and Enterobacteriaceae), and colistin (in Enterobacteriaceae) were observed. Both A. baumannii and K. pneumoniae harbored a wide array of extended-spectrum beta-lactamase genes (bla(TEM), bla(SHV), bla(CTX-M), bla(OXA)). Metallo-beta-lactamase genes (bla(VEB), bla(VIM), bla(NDM)) were detected in carbapenem-resistant strains, at a higher frequency compared to other local reports. We detected two novel mutations in the quinolone-resistant determining region of the gyrA in fluoroquinolone-resistant E. coli (Leu-102-Ala; Gly-105-Val). Microbial resistance to ampicillin, methicillin, and cephalosporins was identified as important risk factors associated with HAIs in the hospital. Conclusion Overall, our findings may provide valuable insight into the microbial resistance pattern and the risk factors of ESKAPEE-associated HAIs in a tertiary hospital located in central Peninsular Malaysia. The data obtained in this study may contribute to informing better hospital infection control in this region.
| Item Type: | Article |
|---|---|
| Funders: | United States of America Naval Medical Research Unit [TWO (NAMRU-2)], United States of America Naval Medical Research Unit [IF004-2020], Armed Forces Health Surveillance Division, Global Emerging Infections Surveillance[P0107_19_NA], Armed Forces Health Surveillance Division, Global Emerging Infections Surveillance[WUN D0016] |
| Uncontrolled Keywords: | AMR-conferring genes;Minimum inhibitory concentration; Molecular epidemiology;Multidrug-resistant organisms; Nosocomial infections;Risk factors analysis |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 16 Jun 2022 07:41 |
| Last Modified: | 16 Jun 2022 07:41 |
| URI: | http://eprints.um.edu.my/id/eprint/34237 |
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