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Logo of anclinmicBioMed CentralBiomed Central Web Sitesearchsubmit a manuscriptregisterthis articleAnnals of Clinical Microbiology and Antimicrobials
 
Ann Clin Microbiol Antimicrob. 2012; 11: 25.
Published online Sep 13, 2012. doi:  10.1186/1476-0711-11-25
PMCID: PMC3475077
Prevalence and genotypic relatedness of carbapenem resistance among multidrug-resistant P. aeruginosa in tertiary hospitals across Thailand
Piyatip Khuntayaporn,1 Preecha Montakantikul,2 Piroon Mootsikapun,3 Visanu Thamlikitkul,4 and Mullika Traidej Chomnawangcorresponding author1
1Department of Microbiology, Faculty of Pharmacy, Mahidol University, 447 Sri Ayudthaya Road, Rachathevi, Bangkok, 10400, Thailand
2Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
3Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
4Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
corresponding authorCorresponding author.
Piyatip Khuntayaporn: piyatip.k/at/gmail.com; Preecha Montakantikul: preecha.mon/at/mahidol.ac.th; Piroon Mootsikapun: piroon_m/at/hotmail.com; Visanu Thamlikitkul: visanu.tha/at/mahidol.ac.th; Mullika Traidej Chomnawang: mullika.tra/at/mahidol.ac.th
Received August 8, 2012; Accepted September 9, 2012.
Abstract
Background
Increased infection caused by multidrug resistant (MDR) Pseudomonas aeruginosa has raised awareness of the resistance situation worldwide. Carbapenem resistance among MDR (CR-MDR) P. aeruginosa has become a serious life-threatening problem due to the limited therapeutic options. Therefore, the objectives of this study were to determine the prevalence, the antibiotic susceptibility patterns and the relatedness of CR-MDR P. aeruginosa in tertiary hospitals across Thailand.
Methods
MDR P. aeruginosa from eight tertiary hospitals across Thailand were collected from 2007–2009. Susceptibility of P. aeruginosa clinical isolates was determined according to the Clinical and Laboratory Standards Institute guideline. Selected CR-MDR P. aeruginosa isolates were genetically analyzed by pulsed-field gel electrophoresis.
Results
About 261 clinical isolates were identified as MDR P. aeruginosa and approximately 71.65% were found to be CR-MDR P. aeruginosa. The result showed that the meropenem resistance rate was the highest reaching over 50% in every hospitals. Additionally, the type of hospitals was a major factor affecting the resistance rate, as demonstrated by significantly higher CR-MDR rates among university and regional hospitals. The fingerprinting map identified 107 clones with at least 95% similarity. Only 4 clones were detected in more than one hospital.
Conclusions
Although the antibiotic resistance rate was high, the spreading of CR-MDR was found locally. Specific strains of CR-MDR did not commonly spread from one hospital to another. Importantly, clonal dissemination ratio indicated limited intra-hospital transmission in Thailand.
Keywords: Antimicrobial susceptibility, Pulsed-field gel electrophoresis, Carbapenem resistance, Multidrug resistance, Pseudomonas aeruginosa, Epidemiology
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