Prevalence and characterization of third-generation cephalosporin, carbapenem and colistin-resistant Enterobacterales isolated from clinical samples in Cambodia
Abstract
Objectives Despite the threat of antimicrobial resistance (AMR) worldwide, limited studies describe the situation in human infections in Cambodia. Our study aims to evaluate the current state of AMR and describe the resistance mechanisms of the main Enterobacterales responsible for various infections in Cambodia. Methods Between January and April 2020, 222 clinical Enterobacterales isolates were collected from routine diagnostics at the Medical Biology Laboratory of the Institut Pasteur du Cambodge, Phnom Penh. Antimicrobial susceptibility testing and resistance phenotype analysis were performed. Beta-lactamase genes bla CTX-M , bla SHV , bla TEM and bla OXA-1 were screened in isolates resistant to third generation cephalosporin (3GC). Carbapenem-resistant isolates were tested for carbapenemase production using a rapid immunochromatographic assay and confirmed by gene detection. Isolates harboring bla CTX-M and carbapenemase genes were further characterized by sequencing. Results Overall, 39.2% of isolates were resistant to at least one 3GC, with 30.2% confirmed as extended-spectrum beta-lactamase (ESBL) producers. The corresponding ESBL genes pertain to the KLUB/CTX-M-1 and KLUY/CTX-M-9 classes. Carbapenemase genes bla NDM and bla OXA–48 were detected in 4.1% of isolates. Notably, 6.5% of ESBL-producing Escherichia coli and Klebsiella pneumoniae also exhibited colistin resistance. Conclusion The prevalence and molecular characterization of 3GC-resistant and ESBL-producing Enterobacterales in our study is consistent with recent reports. Our findings further confirm the high rate of carbapenemase producing Enterobacterales (NDM and OXA-48), including in community-acquired infections. Additionally, we report notable colistin resistance among ESBL producing E. coli and K. pneumoniae isolates. These results highlight the urgent need for AMR strengthened surveillance and antimicrobial stewardship programs in Cambodia.
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BibTeX
@article{delvallez2026prevalence,
title = {{Prevalence and characterization of third-generation cephalosporin, carbapenem and colistin-resistant Enterobacterales isolated from clinical samples in Cambodia}},
author = {Gauthier Delvallez and Sokleaph Cheng and Florian Girond and Sidonn Krang and Soda Meng and Puthea Nop and Seiha Heng and Samrach Han and Sokunthy Keo and Kunthea Kong and Anne-Laure Bañuls and Mallorie Hide},
journal = {New Microbes and New Infections},
year = {2026},
month = sep,
doi = {10.1016/j.nmni.2025.101649},
url = {https://hal.science/hal-05751567v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Prevalence and characterization of third-generation cephalosporin, carbapenem and colistin-resistant Enterobacterales isolated from clinical samples in Cambodia
AU - Gauthier Delvallez
AU - Sokleaph Cheng
AU - Florian Girond
AU - Sidonn Krang
AU - Soda Meng
AU - Puthea Nop
AU - Seiha Heng
AU - Samrach Han
AU - Sokunthy Keo
AU - Kunthea Kong
AU - Anne-Laure Bañuls
AU - Mallorie Hide
PY - 2026
DA - 2026/09/16
JO - New Microbes and New Infections
DO - 10.1016/j.nmni.2025.101649
UR - https://hal.science/hal-05751567v1
AB - Objectives Despite the threat of antimicrobial resistance (AMR) worldwide, limited studies describe the situation in human infections in Cambodia. Our study aims to evaluate the current state of AMR and describe the resistance mechanisms of the main Enterobacterales responsible for various infections in Cambodia. Methods Between January and April 2020, 222 clinical Enterobacterales isolates were collected from routine diagnostics at the Medical Biology Laboratory of the Institut Pasteur du Cambodge, Phnom Penh. Antimicrobial susceptibility testing and resistance phenotype analysis were performed. Beta-lactamase genes bla CTX-M , bla SHV , bla TEM and bla OXA-1 were screened in isolates resistant to third generation cephalosporin (3GC). Carbapenem-resistant isolates were tested for carbapenemase production using a rapid immunochromatographic assay and confirmed by gene detection. Isolates harboring bla CTX-M and carbapenemase genes were further characterized by sequencing. Results Overall, 39.2% of isolates were resistant to at least one 3GC, with 30.2% confirmed as extended-spectrum beta-lactamase (ESBL) producers. The corresponding ESBL genes pertain to the KLUB/CTX-M-1 and KLUY/CTX-M-9 classes. Carbapenemase genes bla NDM and bla OXA–48 were detected in 4.1% of isolates. Notably, 6.5% of ESBL-producing Escherichia coli and Klebsiella pneumoniae also exhibited colistin resistance. Conclusion The prevalence and molecular characterization of 3GC-resistant and ESBL-producing Enterobacterales in our study is consistent with recent reports. Our findings further confirm the high rate of carbapenemase producing Enterobacterales (NDM and OXA-48), including in community-acquired infections. Additionally, we report notable colistin resistance among ESBL producing E. coli and K. pneumoniae isolates. These results highlight the urgent need for AMR strengthened surveillance and antimicrobial stewardship programs in Cambodia.
SN - 2052-2975
SN - 2052-2975
ER -