Bloodstream infection among adults in Phnom Penh, Cambodia: key pathogens and resistance patterns.

<h4>Background</h4>Bloodstream infections (BSI) cause important morbidity and mortality worldwide. In Cambodia, no surveillance data on BSI are available so far.<h4>Methods</h4>From all adults presenting with SIRS at Sihanouk Hospital Centre of HOPE (July 2007-December 2010),...

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Autores principales:	Erika R Vlieghe, Thong Phe, Birgit De Smet, Heng Chhun Veng, Chun Kham, Kruy Lim, Olivier Koole, Lut Lynen, Willy E Peetermans, Jan A Jacobs
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a66a2e23f27d40baa75017c9c2e0d391
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spelling	oai:doaj.org-article:a66a2e23f27d40baa75017c9c2e0d3912021-11-18T07:51:24ZBloodstream infection among adults in Phnom Penh, Cambodia: key pathogens and resistance patterns.1932-620310.1371/journal.pone.0059775https://doaj.org/article/a66a2e23f27d40baa75017c9c2e0d3912013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23555777/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Bloodstream infections (BSI) cause important morbidity and mortality worldwide. In Cambodia, no surveillance data on BSI are available so far.<h4>Methods</h4>From all adults presenting with SIRS at Sihanouk Hospital Centre of HOPE (July 2007-December 2010), 20 ml blood was cultured. Isolates were identified using standard microbiological techniques; antibiotic susceptibilities were assessed using disk diffusion and MicroScan®, with additional E-test, D-test and double disk test where applicable, according to CLSI guidelines.<h4>Results</h4>A total of 5714 samples from 4833 adult patients yielded 501 clinically significant organisms (8.8%) of which 445 available for further analysis. The patients' median age was 45 years (range 15-99 y), 52.7% were women. HIV-infection and diabetes were present in 15.6% and 8.8% of patients respectively. The overall mortality was 22.5%. Key pathogens included Escherichia coli (n = 132; 29.7%), Salmonella spp. (n = 64; 14.4%), Burkholderia pseudomallei (n = 56; 12.6%) and Staphylococcus aureus (n = 53; 11.9%). Methicillin resistance was seen in 10/46 (21.7%) S. aureus; 4 of them were co-resistant to erythromycin, clindamycin, moxifloxacin and sulphamethoxazole-trimethoprim (SMX-TMP). We noted combined resistance to amoxicillin, SMX-TMP and ciprofloxacin in 81 E. coli isolates (62.3%); 62 isolates (47.7%) were confirmed as producers of extended spectrum beta-lactamase. Salmonella isolates displayed high rates of multidrug resistance (71.2%) with high rates of decreased ciprofloxacin susceptibility (90.0%) in Salmonella Typhi while carbapenem resistance was observed in 5.0% of 20 Acinetobacter sp. isolates.<h4>Conclusions</h4>BSI in Cambodian adults is mainly caused by difficult-to-treat pathogens. These data urge for microbiological capacity building, nationwide surveillance and solid interventions to contain antibiotic resistance.Erika R VliegheThong PheBirgit De SmetHeng Chhun VengChun KhamKruy LimOlivier KooleLut LynenWilly E PeetermansJan A JacobsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e59775 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Erika R Vlieghe Thong Phe Birgit De Smet Heng Chhun Veng Chun Kham Kruy Lim Olivier Koole Lut Lynen Willy E Peetermans Jan A Jacobs Bloodstream infection among adults in Phnom Penh, Cambodia: key pathogens and resistance patterns.
description	<h4>Background</h4>Bloodstream infections (BSI) cause important morbidity and mortality worldwide. In Cambodia, no surveillance data on BSI are available so far.<h4>Methods</h4>From all adults presenting with SIRS at Sihanouk Hospital Centre of HOPE (July 2007-December 2010), 20 ml blood was cultured. Isolates were identified using standard microbiological techniques; antibiotic susceptibilities were assessed using disk diffusion and MicroScan®, with additional E-test, D-test and double disk test where applicable, according to CLSI guidelines.<h4>Results</h4>A total of 5714 samples from 4833 adult patients yielded 501 clinically significant organisms (8.8%) of which 445 available for further analysis. The patients' median age was 45 years (range 15-99 y), 52.7% were women. HIV-infection and diabetes were present in 15.6% and 8.8% of patients respectively. The overall mortality was 22.5%. Key pathogens included Escherichia coli (n = 132; 29.7%), Salmonella spp. (n = 64; 14.4%), Burkholderia pseudomallei (n = 56; 12.6%) and Staphylococcus aureus (n = 53; 11.9%). Methicillin resistance was seen in 10/46 (21.7%) S. aureus; 4 of them were co-resistant to erythromycin, clindamycin, moxifloxacin and sulphamethoxazole-trimethoprim (SMX-TMP). We noted combined resistance to amoxicillin, SMX-TMP and ciprofloxacin in 81 E. coli isolates (62.3%); 62 isolates (47.7%) were confirmed as producers of extended spectrum beta-lactamase. Salmonella isolates displayed high rates of multidrug resistance (71.2%) with high rates of decreased ciprofloxacin susceptibility (90.0%) in Salmonella Typhi while carbapenem resistance was observed in 5.0% of 20 Acinetobacter sp. isolates.<h4>Conclusions</h4>BSI in Cambodian adults is mainly caused by difficult-to-treat pathogens. These data urge for microbiological capacity building, nationwide surveillance and solid interventions to contain antibiotic resistance.
format	article
author	Erika R Vlieghe Thong Phe Birgit De Smet Heng Chhun Veng Chun Kham Kruy Lim Olivier Koole Lut Lynen Willy E Peetermans Jan A Jacobs
author_facet	Erika R Vlieghe Thong Phe Birgit De Smet Heng Chhun Veng Chun Kham Kruy Lim Olivier Koole Lut Lynen Willy E Peetermans Jan A Jacobs
author_sort	Erika R Vlieghe
title	Bloodstream infection among adults in Phnom Penh, Cambodia: key pathogens and resistance patterns.
title_short	Bloodstream infection among adults in Phnom Penh, Cambodia: key pathogens and resistance patterns.
title_full	Bloodstream infection among adults in Phnom Penh, Cambodia: key pathogens and resistance patterns.
title_fullStr	Bloodstream infection among adults in Phnom Penh, Cambodia: key pathogens and resistance patterns.
title_full_unstemmed	Bloodstream infection among adults in Phnom Penh, Cambodia: key pathogens and resistance patterns.
title_sort	bloodstream infection among adults in phnom penh, cambodia: key pathogens and resistance patterns.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/a66a2e23f27d40baa75017c9c2e0d391
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Bloodstream infection among adults in Phnom Penh, Cambodia: key pathogens and resistance patterns.

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