Abstract
The surveillance of antimicrobial-resistant isolates has proven to be one of the most valuable tools to understand the global rise of multidrug-resistant bacterial pathogens. We report the first insights into the current situation in the Caribbean, where a pilot project to monitor antimicrobial resistance (AMR) through phenotypic resistance measurements combined with whole-genome sequencing was set up in collaboration with the Caribbean Public Health Agency (CARPHA). Our first study focused on Klebsiella pneumoniae, a highly relevant organism amongst the Gram-negative opportunistic pathogens worldwide causing hospital- and community-acquired infections. Our results show that not only carbapenem resistance, but also hypervirulent strains, are circulating in patients in the Caribbean. Our current data does not allow us to infer their prevalence in the population. We argue for the urgent need to further support AMR surveillance and stewardship in this almost uncharted territory, which can make a significant impact on the reduction of antimicrobial usage. This article contains data hosted by Microreact (https://microreact.org).
Highlights
The increasing level of antimicrobial resistance (AMR) in bacterial pathogens is one of the biggest worldwide threats for public health [1]
The spread is amplified as mobile resistance elements can cross both geographical and species borders, and the Enterobacteriaceae are especially prone to disseminating plasmids encoding AMR genes [2]
We report the results of the first two surveys of isolates collected across the Caribbean Public Health Agency (CARPHA) member states (CMS)
Summary
The increasing level of antimicrobial resistance (AMR) in bacterial pathogens is one of the biggest worldwide threats for public health [1]. The spread is amplified as mobile resistance elements can cross both geographical and species borders, and the Enterobacteriaceae are especially prone to disseminating plasmids encoding AMR genes [2]. The mobility of people today, greatly contributes to their worldwide spread. The phenomenon has been recognized by the major publichealth agencies, and several surveillance programmes have been set in place to assess the prevalence of AMR in bacteria. This facilitates more informed decisions for interventions, guidelines for AMR practice and contributes to our understanding of the mechanisms leading to dissemination of AMR and the emergence of new resistances or high-risk lineages [1]
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