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Acinetobacter spp. infections in Malaysia: a review of antimicrobial resistance trends, mechanisms and epidemiology

Acinetobacter spp. infections in Malaysia: a review of antimicrobial resistance trends, mechanisms and epidemiology
Acinetobacter spp. infections in Malaysia: a review of antimicrobial resistance trends, mechanisms and epidemiology

Acinetobacter spp. are important nosocomial pathogens, in particular the Acinetobacter baumannii-calcoaceticus complex, which have become a global public health threat due to increasing resistance to carbapenems and almost all other antimicrobial compounds. High rates of resistance have been reported among countries in Southeast Asia, including Malaysia. In this review, we examine the antimicrobial resistance profiles of Acinetobacter spp. hospital isolates from Malaysia over a period of nearly three decades (1987-2016) with data obtained from various peer-reviewed publications as well as the Malaysian National Surveillance on Antibiotic Resistance (NSAR). NSAR data indicated that for most antimicrobial compounds, including carbapenems, the peak resistance rates were reached around 2008-2009 and thereafter, rates have remained fairly constant (e.g., 50-60% for carbapenems). Individual reports from various hospitals in Peninsular Malaysia do not always reflect the nationwide resistance rates and often showed higher rates of resistance. We also reviewed the epidemiology and mechanisms of resistance that have been investigated in Malaysian Acinetobacter spp. isolates, particularly carbapenem resistance and found that blaOXA-23 is the most prevalent acquired carbapenemase-encoding gene. From the very few published reports and whole genome sequences that are available, most of the Acinetobacter spp. isolates from Malaysia belonged to the Global Clone 2 (GC2) CC92 group with ST195 being the predominant sequence type. The quality of data and analysis in the national surveillance reports could be improved and more molecular epidemiology and genomics studies need to be carried out for further in-depth understanding of Malaysian Acinetobacter spp. isolates.

Journal Article, Review
1664-302X
2479
Mohd Rani, Farahiyah
1a1e50e5-e44e-445e-83ef-c7039a713620
Rahman, Nor Iza A.
b4d18282-a17c-4cfd-9f6d-389642907c48
Ismail, Salwani
beb95eb3-3e79-4c48-a040-9994c7b5abce
Alattraqchi, Ahmed Ghazi
dade11e6-1d45-4351-96a5-ed751091e200
Cleary, David W.
f4079c6d-d54b-4108-b346-b0069035bec0
Clarke, Stuart C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17
Yeo, Chew Chieng
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Mohd Rani, Farahiyah
1a1e50e5-e44e-445e-83ef-c7039a713620
Rahman, Nor Iza A.
b4d18282-a17c-4cfd-9f6d-389642907c48
Ismail, Salwani
beb95eb3-3e79-4c48-a040-9994c7b5abce
Alattraqchi, Ahmed Ghazi
dade11e6-1d45-4351-96a5-ed751091e200
Cleary, David W.
f4079c6d-d54b-4108-b346-b0069035bec0
Clarke, Stuart C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17
Yeo, Chew Chieng
fdccc646-7c5d-4231-a9fa-ff01c39f4e5a

Mohd Rani, Farahiyah, Rahman, Nor Iza A., Ismail, Salwani, Alattraqchi, Ahmed Ghazi, Cleary, David W., Clarke, Stuart C. and Yeo, Chew Chieng (2017) Acinetobacter spp. infections in Malaysia: a review of antimicrobial resistance trends, mechanisms and epidemiology. Frontiers in Microbiology, 8, 2479. (doi:10.3389/fmicb.2017.02479).

Record type: Review

Abstract

Acinetobacter spp. are important nosocomial pathogens, in particular the Acinetobacter baumannii-calcoaceticus complex, which have become a global public health threat due to increasing resistance to carbapenems and almost all other antimicrobial compounds. High rates of resistance have been reported among countries in Southeast Asia, including Malaysia. In this review, we examine the antimicrobial resistance profiles of Acinetobacter spp. hospital isolates from Malaysia over a period of nearly three decades (1987-2016) with data obtained from various peer-reviewed publications as well as the Malaysian National Surveillance on Antibiotic Resistance (NSAR). NSAR data indicated that for most antimicrobial compounds, including carbapenems, the peak resistance rates were reached around 2008-2009 and thereafter, rates have remained fairly constant (e.g., 50-60% for carbapenems). Individual reports from various hospitals in Peninsular Malaysia do not always reflect the nationwide resistance rates and often showed higher rates of resistance. We also reviewed the epidemiology and mechanisms of resistance that have been investigated in Malaysian Acinetobacter spp. isolates, particularly carbapenem resistance and found that blaOXA-23 is the most prevalent acquired carbapenemase-encoding gene. From the very few published reports and whole genome sequences that are available, most of the Acinetobacter spp. isolates from Malaysia belonged to the Global Clone 2 (GC2) CC92 group with ST195 being the predominant sequence type. The quality of data and analysis in the national surveillance reports could be improved and more molecular epidemiology and genomics studies need to be carried out for further in-depth understanding of Malaysian Acinetobacter spp. isolates.

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fmicb-08-02479 - Version of Record
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More information

Accepted/In Press date: 29 November 2017
e-pub ahead of print date: 12 December 2017
Published date: 2017
Keywords: Journal Article, Review

Identifiers

Local EPrints ID: 421587
URI: https://eprints.soton.ac.uk/id/eprint/421587
ISSN: 1664-302X
PURE UUID: 3cc01ea9-4d8c-4f29-9b17-3e92b841926c
ORCID for David W. Cleary: ORCID iD orcid.org/0000-0003-4533-0700
ORCID for Stuart C. Clarke: ORCID iD orcid.org/0000-0002-7009-1548

Catalogue record

Date deposited: 15 Jun 2018 16:30
Last modified: 03 Dec 2019 01:46

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