Affiliations: *National Institute of Health, Department of Medical Sciences, Nonthaburi 11000, Thailand. Tel. 662 951 0000 ext. 99415. Fax 662 985 9867
** Thammasart University, Pratumthani, Thailand
***Washington University School of Medicine, St. Louis, MO, USA
Source: Poster presentation in The 9th Western Pacific Congress on Chemotherapy and Infectious Diseases (9th WPCCID) “Regional Infectious Disease Problems of Global Concern” December 1-5, 2004. Queen Sirikit Convention Center, Bangkok, Thailand. Program & Abstracts page 185
Introduction: Limited data is available concerning the prevalence and resistant patterns of gram-negative bacilli (GNB) causing bloodstream infections (BSIs) in Thailand.
Objective: To report the National Susceptibility Data of 7 most common GNB causing BSIs submitted to the National Antimicrobial Resistant Surveillance Center, Thailand (NARST) from 2000-2003.
Methods: Data ofantimicrobial susceptibility patterns of 7 most common GNB causing BSI collected from 33 hospitals 2000 to 2003 were reviewed. At each hospital laboratory, bacterial cultivation and identification were performed using of standard conventional methods. Antimicrobial disk susceptibility test and interpretation were according to the National Committee for Clinical Laboratory Standards (NCCLS). Patient data and inhibition zone in mm. were input in WHONET software and sent to the National Institute of Health, Thailand for analysis.
Results: Of 25,459 BSI isolates, the prevalence of 7 most common GNB were Escherichia coli 43.8%, Klebsiella pneumonaie 20%, Pseudomonas aeruginosa 19.6%, Salmonella non-typhi 8.7%, Acinetobactor baumannii 7.1%, Burkholderia pseudomallei 7% and Enterobacter cloacae 3.4%. Resistance of the Enterobacteriaceae species to most of the commonly prescribed first line antimicrobials in Thailand, such as, ampicillin (98% in K. pneumoniae, 72% in E. coli), gentamicin (21% in K. pneumoniae, 15%E. coli), and co-trimoxazole (59% in E. coli, 32% in K. pneumoniae) was high. Resistant to certain broad-spectrum antimicrobials, such as, ESBL producing K. pneumoniae (33%), ESBL producing E. coli (15%), ceftazidime resistant A. baumanii (44%), ciprofloxacin resistant E. coli (21%), and imipenem resistant A. baumanii (16%) was high. There is a trend of increased resistance of these selected microorganisms over time. Differences in geographic regions were associated with certain forms of resistance.
Conclusions: Antimicrobial resistance among gram-negative bacilli causing bloodstream infections is prevalence in Thailand. Attempt should be made to control for antimicrobial utilization and to develop a better surveillance system for the country.