ABSTRACT
Antimicrobial resistance (AMR) is a concern in medical care for children who have high burden of infectious diseases. We investigated the prevalence of bacterial species and their susceptibility to antimicrobials of 1019 clinical isolates from pediatric patients in a tertiary-care hospital in Yangon, Myanmar for one-year period (2020). The most frequently recovered species was Escherichia coli, followed by Klebsiella pneumoniae and Staphylococcus aureus, all of which accounted for 43% of clinical isolates, while 25% of isolates comprised non-fermenter, including Pseudomonas sp. and Acinetobacter sp. Phenotypically determined ESBL (extended-spectrum beta-lactamase)-positive rates in E. coli, K. pneumoniae, and Enterobacter sp. were 82%, 88%, and 65%, respectively. High rates of multiple drug resistance were noted for E. coli (84%), K. pneumoniae (81%), and Acinetobacter sp. (65%), associated with carbapenem resistance in 48%, 42%, and 59% of isolates, respectively. In contrast, S. aureus isolates exhibited low resistance rates (<30%) to most of antimicrobials, with 22% being resistant to oxacillin/cefoxitin. Fluoroquinolone resistance was found in most of bacterial species with different prevalence rates. The present study revealed the current status on prevalence of bacterial species causing infections in pediatric patients in Myanmar, highlighting the significance to monitor AMR among children.
ABSTRACT
The spread of multidrug-resistant and virulent Staphylococcus aureus among children is a public health concern, but the actual conditions in Myanmar have not been characterized. In this study, a total of 244 clinical isolates of S. aureus collected from pediatric patients in Yangon Children's Hospital during a 1-year period were analyzed for their drug resistance and genetic features. Methicillin-resistant S. aureus (MRSA) accounted for 19.7% of isolates associated with staphylococcal cassette chromosome mec (SCCmec) type III, IV, or V. Panton-Valentine leukocidin (PVL) genes were detected in 61.5% of all isolates, with a significantly higher prevalence in methicillin-susceptible S. aureus (MSSA; 67.9%) than in MRSA (35.4%) isolates. Sequence type (ST) 239/SCCmec-III was the most common MRSA clone lacking PVL genes, while PVL-positive MRSA belonged to mostly ST361/SCCmec-V and ST772/SCCmec-V. Among MSSA isolates, ST121, ST2990, ST88, and ST1930 were dominant, harboring mostly PVL genes. ST239 MRSA isolates exhibited the highest resistance rates to antimicrobials, and quinolone resistance was found in the dominant MRSA clones (ST239, ST361, and ST772) and some MSSA lineages. The present study revealed the prevalence and clonal diversity of MRSA/MSSA in children in Myanmar in relation to drug resistance and virulence determinants.
