Abstract
BackgroundEmerging antibiotic resistance amongst clinically significant bacteria is a public health issue of increasing significance worldwide, but it is relatively uncharacterized in Cambodia. In this study we performed standard bacterial cultures on samples from wounds at a Non-Governmental-Organization (NGO) Hospital in Phnom Penh, Cambodia. Testing was performed to elucidate pathogenic bacteria causing wound infections and the antibiotic resistance profiles of bacterial isolates. All testing was performed at the Naval Medical Research Unit, No.2 (NAMRU-2) main laboratory in Phnom Penh, Cambodia.MethodsBetween 2011–2013, a total of 251 specimens were collected from patients at the NGO hospital and analyzed for bacterial infection by standard bacterial cultures techniques. Specimens were all from wounds and anonymous. No specific clinical information accompanied the submitted specimens. Antibiotic susceptibility testing, and phenotypic testing for extended-spectrum beta-lactamase (ESBL) were performed and reported based on CLSI guidelines. Further genetic testing for CTX-M, TEM and SHV ESBLs was accomplished using PCR.ResultsOne-hundred and seventy-six specimens were positive following bacterial culture (70 %). Staphlycoccus aureus was the most frequently isolated bacteria. Antibiotic drug resistance testing revealed that 52.5 % of Staphlycoccus aureus isolates were oxacillin resistant. For Escherichia coli isolates, 63.9 % were ciprofloxacin and levofloxacin resistant and 96 % were ESBL producers. Resistance to meropenem and imipenem was observed in one of three Acinetobacter spp isolates.ConclusionsThis study is the first of its kind detailing the antibiotic resistance profiles of pathogenic bacteria causing wound infections at a single surgical hospital in Cambodia. The reported findings of this study demonstrate significant antibiotic resistance in bacteria from injured patients and should serve to guide treatment modalities in Cambodia.
Highlights
Emerging antibiotic resistance amongst clinically significant bacteria is a public health issue of increasing significance worldwide, but it is relatively uncharacterized in Cambodia
Well documented examples include the spread of specific methicillin-resistant S. aureus (MRSA) clones around the world capable of outcompeting pre-existing local populations [3, 4]; the emergence of Enterobacteriaceae with resistance to carbapenems conferred by New Delhi metallo-β-lactamase 1 (NDM-1) from India and Pakistan [5]; and the global spread of multidrug resistant Acinetobacter species [6]
In this study we focus on the etiologic causes of wound infections at a Non-Governmental-Organization (NGO) surgical hospital in Phnom Penh, Cambodia, and describe the drug resistance profiles of those agents
Summary
Emerging antibiotic resistance amongst clinically significant bacteria is a public health issue of increasing significance worldwide, but it is relatively uncharacterized in Cambodia. Well documented examples include the spread of specific methicillin-resistant S. aureus (MRSA) clones around the world capable of outcompeting pre-existing local populations [3, 4]; the emergence of Enterobacteriaceae with resistance to carbapenems conferred by New Delhi metallo-β-lactamase 1 (NDM-1) from India and Pakistan [5]; and the global spread of multidrug resistant Acinetobacter species [6]. A recent large study into bacterial causes of blood stream infections at a community hospital in Phnom Penh from 2007–2010 demonstrated high level antibiotic resistance patterns to include an observed 62.3 % resistance of E. coli isolates to ciprofloxacin, 90 % of Salmonella typhi isolates having decreased susceptibility to ciprofloxacin, and 21.7 % of S. aureus isolates being resistance to methicillin [11]
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