Prediction of major antibiotic resistance in Escherichia coli and Klebsiella pneumoniae in Singapore, USA and China using a limited set of gene targets

Andrew N Ginn; Agnieszka M Wiklendt; Zhiyong Zong; Raymond T P Lin; Jeanette W P Teo; Paul A Tambyah; Lance R Peterson; Karen Kaul; Sally R Partridge; Jonathan R Iredell

doi:10.1016/j.ijantimicag.2014.02.010

Prediction of major antibiotic resistance in Escherichia coli and Klebsiella pneumoniae in Singapore, USA and China using a limited set of gene targets

Int J Antimicrob Agents. 2014 Jun;43(6):563-5. doi: 10.1016/j.ijantimicag.2014.02.010. Epub 2014 Mar 27.

Authors

Affiliations

¹ Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead Hospital, Sydney, NSW, Australia; Centre for Research Excellence in Critical Infection and Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia; Westmead Millennium Institute, Westmead, NSW, Australia.
² Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead Hospital, Sydney, NSW, Australia.
³ Department of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
⁴ Department of Laboratory Medicine, National University Health System, Singapore; Department of Microbiology and Department of Pathology, National University of Singapore, Singapore.
⁵ Department of Laboratory Medicine, National University Health System, Singapore.
⁶ Department of Medicine, National University of Singapore, Singapore; University Medical Cluster, National University Health System, Singapore.
⁷ Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, IL, USA; Department of Medicine, NorthShore University HealthSystem, IL, USA; University of Chicago, Pritzker School of Medicine, Chicago, IL, USA.
⁸ Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, IL, USA; University of Chicago, Pritzker School of Medicine, Chicago, IL, USA.
⁹ Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead Hospital, Sydney, NSW, Australia; Centre for Research Excellence in Critical Infection and Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia; Westmead Millennium Institute, Westmead, NSW, Australia. Electronic address: jonathan.iredell@sydney.edu.au.

PMID: 24721234
DOI: 10.1016/j.ijantimicag.2014.02.010

Abstract

Antibiotic resistance in Gram-negative bacteria, especially Enterobacteriaceae, can be conferred by a large number of different acquired resistance genes, although it appears that relatively few dominate. A previous survey of Escherichia coli and Klebsiella pneumoniae isolates from Sydney, Australia, revealed that a limited set of genes could reliably predict resistance to third-generation cephalosporins (3GCs) and aminoglycosides. Here we tested E. coli and K. pneumoniae isolates with a cefotaxime, ceftriaxone and/or ceftazidime minimum inhibitory concentration of ≥ 2 μg/mL from China and Singapore, with significantly higher resistance rates than Australia, as well as the USA. Few targets were needed to predict non-susceptibility to 3GCs (95/95; 100%) and gentamicin (47/51; 92%). The gene types detected here are consistent with previous surveys in similar countries with similar resistance rates, where the majority of 3GC resistance can be explained by blaCTX-M genes. This study identified a limited set of genes capable of predicting resistance to 3GC and aminoglycoside antibiotics and implies a restriction in the global resistance gene pool that can be exploited for diagnostic purposes.

Keywords: Antibiotic resistance; Diagnostic targets; Enterobacteriaceae; Genetic diversity; Global.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / pharmacology
Cefotaxime / pharmacology
Ceftazidime / pharmacology
Ceftriaxone / pharmacology
China
Drug Resistance, Bacterial*
Escherichia coli / drug effects*
Escherichia coli / genetics*
Escherichia coli / isolation & purification
Escherichia coli Infections / microbiology
Genes, Bacterial*
Gentamicins / pharmacology
Humans
Klebsiella Infections / microbiology
Klebsiella pneumoniae / drug effects*
Klebsiella pneumoniae / genetics*
Klebsiella pneumoniae / isolation & purification
Microbial Sensitivity Tests
Singapore
United States

Substances

Anti-Bacterial Agents
Gentamicins
Ceftriaxone
Ceftazidime
Cefotaxime