Thursday, 26 December 2019

Bacterial resistance to two critical antibiotics widespread in Southeast Asia

Resistance to two critical antibiotic types, one a "drug of last resort" when all others fail against some "superbugs," are widely distributed in Southeast Asia, raising the risk of untreatable infections, say a team of investigators led by Georgetown University Medical Center.

The study is a comprehensive analysis of resistance to two critical classes of drugs, carbapenems and polymyxins, in eleven nations of Southeast Asia.

The World Health Organization (WHO) has urgently called for global surveillance of antibiotic resistance, and, along with U.S. Centers for Disease Control and Prevention (CDC), identified resistance to these drugs as critical threats. To help better understand the risk in Southeast Asia, the researchers searched widely, extracting and analyzing available international scientific and clinical data. They evaluated resistance to these drugs among E. coli and Klebsiella, two common bacteria that can cause severe infections in humans, particularly in health care settings.

The picture the data paints is of a serious emerging public health threat. The investigators' findings included that resistance to carbapenems, often at significant levels, and resistance to polymyxins, were each widespread and geographically overlapped in 8 countries. Both bacteria also carry and can spread "mobile genetic elements" which can contain genes responsible for conferring resistance that may be transmitted to other bacteria, facilitating the rapid spread of resistance.

Carbapenems have, until recently, been the "go to" treatment for E. coli and Klesiella resistant to more commonly used drugs. However, carbapenem resistant strains have spread around the world.


Marissa D. Malchione, Laura M. Torres, David M. Hartley, Michala Koch, Jesse Goodman. Carbapenem and Colistin Resistance in Enterobacteriaceae in Southeast Asia: Review and Mapping of Emerging and Overlapping Challenges. International Journal of Antimicrobial Agents, 2019; DOI: 10.1016/j.ijantimicag.2019.07.019

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

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