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1656. Klebsiella pneumoniae Antimicrobial Susceptibility to Carbapenems in Latin America Between 2000 and 2014
BACKGROUND: Antimicrobial resistance (AMR) to carbapenems in Enterobacteriaceae such as Klebsiella pneumoniae (KPN) is a major global public health concern. Infections caused by these pathogens are associated with high morbidity and mortality and perpetuated by limited safe alternative treatment opt...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809629/ http://dx.doi.org/10.1093/ofid/ofz360.1520 |
Sumario: | BACKGROUND: Antimicrobial resistance (AMR) to carbapenems in Enterobacteriaceae such as Klebsiella pneumoniae (KPN) is a major global public health concern. Infections caused by these pathogens are associated with high morbidity and mortality and perpetuated by limited safe alternative treatment options. This study aims to describe the antimicrobial susceptibility patterns amongst KPN to the carbapenems Latin America. METHODS: Surveillance laboratory data from 2000 to 2014 were obtained through the ReLAVRA network from 19 countries in Latin America. Longitudinal trends of mean percentage non-susceptibility for the region were conducted and evaluated with a significance level of P < 0.05. RESULTS: A total of 209,972 and 181,128 KPN isolates were reported from 2000 to 2014 for antibiotic susceptibility to imipenem and meropenem, respectively. From 2000 to 2014 an increasing trend was observed in the reported % KPN NS to imipenem (P < 0.0001) from 0.6% to 11.6% with an average annual percentage increase (AAPI) of 36.3% [95% CI: 39.8%–33%]. (Figure 1). Similarly, the % KPN NS to meropenem increased (P < 0.0001) from 0% in 2000 to 12.3% in 2014 with an AAPI of 49.5% [95% CI: 54%–44.6%] (Figure 2). For both antibiotics, the last 5 years of the timeframe (2010 to 2014) showed the highest rate of increase in NS. NS to carbapenems varied significantly between reporting countries, with the highest % KPN NS to imipenem and meropenem reported by Brazil, Guatemala, Nicaragua, and Peru. CONCLUSION: The increase in KPN NS to carbapenems observed in Latin America threatens effective treatment of infections caused by this pathogen. The extremely limited treatment options could lead to further increases in morbidity and mortality. Strengthening health systems and core country capacity to identify and deal with these emerging high-risk pathogens and resistance mechanisms, through surveillance is vital to inform public health actions, control measures, mitigate outbreaks and support further development of Public health actions against AMR at country and regional level. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. |
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