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Table 2 Antimicrobial resistance and temporal trends among community-onset (CO) and hospital-onset (HO) BSI pathogens in Sa Kaeo and Nakhon Phanom provinces, Thailand, 2007-2014

From: Population-based bloodstream infection surveillance in rural Thailand, 2007–2014

  CO HO
Antimicrobial resistance issue % Resistanta (n/N tested) Temporal Trends % Resistanta (n/N tested) Temporal Trends
Extended-spectrum beta-lactamase (ESBL) producing E. colib 27% (763/3047) Increased from 20% in 2008-2010 to 28% in 2011-2014 51% (105/203) No clear trend, range:
38% in 2010 to 69% in 2011
ESBL producing K. pneumoniae 23% (213/912) No clear trend, range:
19% in 2014 to 30% in 2012
55% (68/123) No clear trend, range:
23% in 2009 to 75% in 2013
Carbapenem-resistant Enterobacteriaceae (CRE) 5 cases No cases before 2011. 5 cases total : 2011 (1), 2013 (1), 2014 (3) 3 cases No cases before 2012. 3 cases total: 2012 (2), 2014 (1).
Methicillin-resistant S. aureus (MRSA)c 7% (55/744) No clear trend 20% (22/111) No clear trend
Vancomycin-resistant S. aureus (VRSA)d 0 0% 0 0%
Penicillin-resistant S. pneumoniaee 0 0% 0 0%
Carbapenem-resistant Acinetobacter spp. 34% (84/242) Increased from 16% in 2007 to >40% in 2008 and then decreased to 23% in 2014 69% (101/146) No clear trend, range: 91% in 2010 to 46% in 2012
MDR Acinetobacter spp.f 26% (56/219) Increased from <10% in 2007 to >45% in 2010; no clear trend from 2011 (35%) to 2014 (23%) 70% (97/138) Decrease of borderline significance (p<0.10) from 2008 to 2014
  1. aCalculated among isolates tested
  2. bData available for 2008-2014. ESBL-producing criteria: ≥5 mm increase in the zone of growth inhibition of ceftazidime/clavulanic acid combination disc compared to ceftazidime or cefotaxime discs alone. If confirmatory testing was not available, ESBL screening test results were used: zone of inhibition for ceftazidime ≤22 mm or cefotaxime ≤27 mm
  3. cMRSA criteria: prior to 2007, oxacillin disk diffusion with a zone of inhibition <10mm; from 2007, cefoxitin disk diffusion with a zone of inhibition <21 mm
  4. dVRSA criteria: MRSA isolates tested for vancomycin minimum inhibitory concentration (MIC) ≤2 ug/ml as determined by E-test (bioMérieux, U.S.A.)
  5. ePenicillin resistance criteria: oxacillin disc diffusion zone of inhibition <20 mm with confirmation by a penicillin MIC ≥8 μg/mL by E-test
  6. fMDR Acinetobacter criteria: resistant to 3 or more drug classes: aminoglycosides, cephalosporins, fluoroquinolones, carbapenems
  7. gCRE criteria: resistant to imipenem, meropenem, doripenem, or ertapenem by disc diffusion (zone of inhibition <20 mm)