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Volume 24, Number 5—May 2018
Synopsis

Antimicrobial Resistance in Invasive Bacterial Infections in Hospitalized Children, Cambodia, 2007–2016

Andrew Fox-LewisComments to Author , Junko Takata, Thyl Miliya, Yoel Lubell, Sona Soeng, Poda Sar, Kolthida Rith, Gregor McKellar, Vanaporn Wuthiekanun, Erin McGonagle, Nicole Stoesser, Catrin E. Moore, Christopher M. Parry, Claudia Turner, Nicholas P.J. Day, Ben S. Cooper, and Paul Turner
Author affiliations: University of Oxford, Oxford, UK (A. Fox-Lewis, J. Takata, Y. Lubell, N. Stoesser, C.E. Moore, C. Turner, N.P.J. Day, B.S. Cooper, P. Turner); Angkor Hospital for Children, Siem Reap, Cambodia (A. Fox-Lewis, T. Miliya, S. Soeng, P. Sar, K. Rith, G. McKellar, C. Turner, P. Turner); Cambodia-Oxford Medical Research Unit, Siem Reap (A. Fox-Lewis, T. Miliya, S. Soeng, P. Sar, K. Rith, C. Turner, P. Turner); Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand (Y. Lubell, V. Wuthiekanun, C.E. Moore, N.P.J. Day, B.S. Cooper); University of Colorado, Aurora, Colorado, USA (E. McGonagle); Liverpool School of Tropical Medicine, Liverpool, UK (C.M. Parry); Nagasaki University, Nagasaki, Japan (C.M. Parry)

Main Article

Table 1

Resistance proportions by year of isolation for the 1,088 Global Antimicrobial Resistance Surveillance System pathogens isolated from children at Angkor Hospital for Children, Siem Reap, Cambodia, 2007–2016*

Pathogen, resistance type No. isolates resistant/no. tested (%) Year of isolation
2007–2008 2009–2010 2011–2012 2013–2014 2015–2016
Gram-negative
Klebsiella pneumoniae 146 11 17 56 42 20
AMP–GEN† 90/145 (62.1) 5/11 (45.5) 10/16 (62.5) 46/56 (82.1) 26/42 (61.9) 3/20 (15.0)
3GC 115/146 (78.8) 8/11 (72.7) 13/17 (76.5) 50/56 (89.3) 37/42 (88.1) 7/20 (35.0)
Carbapenem 1/142 (0.7) 0/8 0/16 0/56 1/42 (2.4) 0/20
Multidrug 108/132 (81.8) 8/8 (100) 12/12 (100) 45/50 (90.0) 36/42 (85.7) 7/20 (35.0)
Escherichia coli 107 12 22 21 30 22
AMP–GEN 50/106 (47.2) 4/12 (33.3) 12/21 (57.1) 8/21 (38.1) 17/30 (56.7) 9/22 (40.9)
    AMP 101/107 (94.4) 10/12 (83.3) 21/22 (95.5) 21/21 (100) 28/30 (93.3) 21/22 (95.5)
    GEN 51/106 (48.1) 4/12 (33.3) 12/21 (57.1) 8/21 (38.1) 18/30 (60.0) 9/22 (40.9)
3GC 53/107 (49.5) 3/12 (25.0) 11/22 (50.0) 11/21 (52.4) 16/30 (53.3) 12/22 (54.5)
Carbapenem 0/98 0/3 0/22 0/21 0/30 0/22
Multidrug 69/84 (82.1) 3/3 (100) 13/13 (100) 15/16 (93.8) 23/30 (76.7) 15/22 (68.2)
Acinetobacter baumannii 75 2 7 30 27 9
3GC 70/75 (93.3) 2/2 (100) 6/7 (85.7) 27/30 (90.0) 27/27 (100) 8/9 (88.9)
Carbapenem 10/74 (13.5) 1/2 (50.0) 1/6 (16.7) 5/30 (16.7) 3/27 (11.1) 0/9
Multidrug 21/71 (29.6) 1/2 (50.0) 2/6 (33.3) 9/27 (33.3) 8/27 (29.6) 1/9 (11.1)
Salmonella Typhi 323 44 51 146 40 42
FQ 308/322 (95.7) 39/44 (88.6) 48/51 (94.1) 139/145 (95.9) 40/40 (100) 42/42 (100)
CRO 1/173 (0.6) 0/44 1/21 (4.8) 0/26 0/40 0/42
MDR 270/314 (86.0) 31/41 (75.6) 39/47 (83.0) 134/144 (93.1) 35/40 (87.5) 31/42 (73.8)
FQ and multidrug 266/313 (85.0) 30/41 (73.2) 38/47 (80.9) 132/143 (92.3) 35/40 (87.5) 31/42 (73.8)
Salmonella Paratyphi A 44 3 0 0 35 6
FQ 10/44 (22.7) 3/3 (100) 4/35 (11.4) 3/6 (50.0)
CRO 0/44 0/3 0/35 0/6
MDR 0/43 0/2 0/35 0/6
FQ and multidrug 0/0 0/0 0/0 0/0
Non-Typhoid Salmonellae 41 7 4 7 9 14
FQ 26/41 (63.4) 4/7 (57.1) 2/4 (50.0) 4/7 (57.1) 6/9 (66.7) 10/14 (71.4)
CRO 3/37 (8.1) 0/7 0/4 1/3 (33.3) 0/9 2/14 (14.3)
Multidrug 9/39 (23.1) 3/7 (42.9) 1/2 (50.0) 2/7 (28.6) 2/9 (22.2) 1/14 (7.1)
FQ and multidrug
 5/39 (12.8)
 3/7 (42.9)
 1/2 (50.0)
 0/7
 0/9
 1/14 (7.1)
Gram-positive
Staphylococcus aureus 186 26 38 43 42 37
MET 24/185 (13.0) 3/26 (11.5) 4/38 (10.5) 8/42 (19.0) 3/42 (7.1) 6/37 (16.2)
VAN 0/9 0/0 0/0 0/0 0/3 0/6
Streptococcus pneumoniae 166 17 36 40 41 32
Penicillin 73/144 (50.7) 5/9 (55.6) 10/23 (43.5) 16/39 (41.0) 20/41 (48.8) 22/32 (68.8)
MAC/LIN 49/165 (29.7) 5/17 (29.4) 10/35 (28.6) 12/40 (30.0) 11/41 (26.8) 11/32 (34.4)
MDR 63/93 (67.7) 0/0 0/0 10/20 (50.0) 26/41 (63.4) 27/32 (84.4)

*Resistance proportions are reported as no. resistant isolates/no. isolates tested. Blank cells indicate that no organisms were tested during that period and, thus, the proportion of resistant organisms is unknown. 3GC, third-generation cephalosporin; AMP–GEN, resistance to both ampicillin and gentamicin; CRO, ceftriaxone; FQ, fluoroquinolone; MDR, multidrug resistant; MAC/LIN, resistance to macrolides and/or lincosamides; MET, methicillin; VAN, vancomycin.
†K. pneumoniae is intrinsically resistant to AMP, and thus AMP–GEN resistance in K. pneumoniae isolates is equivalent to GEN resistance.

Main Article

Page created: April 17, 2018
Page updated: April 17, 2018
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