https://scholars.lib.ntu.edu.tw/handle/123456789/479670
標題: | Nationwide surveillance of antimicrobial resistance among clinically important Gram-negative bacteria, with an emphasis on carbapenems and colistin: Results from the Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART) in 2018 | 作者: | Lee Y.-L. Lu M.-C. PEI-LAN SHAO Lu P.-L. Chen Y.-H. Cheng S.-H. Ko W.-C. Lin C.-Y. Wu T.-S. Yen M.-Y. Wang L.-S. Liu C.-P. Lee W.-S. Shi Z.-Y. Chen Y.-S. Wang F.-D. Tseng S.-H. Lin C.-N. Chen Y.-H. WANG-HUEI SHENG Lee C.-M. Liao M.-H. PO-REN HSUEH |
公開日期: | 2019 | 卷: | 54 | 期: | 3 | 起(迄)頁: | 318-328 | 來源出版物: | International Journal of Antimicrobial Agents | 摘要: | Multicentre surveillance of antimicrobial susceptibility of clinically important Gram-negative bacteria (GNB) from 16 Taiwanese hospitals was performed. Escherichia coli (n = 398), Klebsiella pneumoniae (n = 346), Pseudomonas aeruginosa (n = 252) and Acinetobacter baumannii complex (ABC) (n = 188) bloodstream isolates, non-typhoidal Salmonella (n = 230) and Shigella flexneri (n = 18) from various sources were collected. Antimicrobial MICs were determined using broth microdilution. Genes encoding K. pneumoniae carbapenemases (KPCs), New Delhi metallo-β-lactamases (NDMs), Verona integron-encoded metallo-β-lactamase (VIM), OXA-48-like carbapenemase (OXA-48) as well as mcr-1–5 genes were detected by molecular methods. Rates of carbapenem non-susceptibility were 2.8%, 9.0%, 0.4%, 0%, 10.3% and 48.8% for E. coli, K. pneumoniae, Salmonella, Shigella, P. aeruginosa and ABC, respectively. For carbapenemases, one (0.3%) E. coli harboured blaNDM-1. Fifteen (4.3%), two (0.6%) and two (0.6%) K. pneumoniae contained blaKPC, blaOXA-48 and blaVIM, respectively. Two (0.5%) E. coli and fourteen (4.0%) K. pneumoniae were non-wild-type according to the colistin MIC. Among Enterobacteriaceae with a colistin MIC ? 2 mg/L, mcr-1 was detected in one E. coli, two K. pneumoniae and three Salmonella spp. All three mcr-1-positive Salmonella isolates were collected from community-acquired infections; none of the six mcr-1-positive Enterobacteriaceae were carbapenem-resistant. Carbapenem resistance has increased among clinically important GNB, especially among hospital-acquired infections. blaKPC, especially the blaKPC-2 variant, was detected in approximately one-half of the carbapenem-resistant K. pneumoniae isolates in this study. Although resistance rates to colistin remained low among Enterobacteriaceae, the finding of mcr-1 from different species raises concern of potential dissemination. ? 2019 |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/479670 | ISSN: | 0924-8579 | DOI: | 10.1016/j.ijantimicag.2019.06.009 | SDG/關鍵字: | carbapenem; carbapenemase; colistin; metallo beta lactamase; antiinfective agent; carbapenem derivative; colistin; Acinetobacter baumannii; antibiotic resistance; antibiotic sensitivity; Article; bacterial gene; bacterium isolate; bacterium isolation; broth dilution; community acquired infection; controlled study; disease surveillance; Escherichia coli; gene; gene identification; Gram negative bacterium; Klebsiella pneumoniae; mcr 1 gene; mcr 2 gene; mcr 3 gene; mcr 4 gene; mcr 5 gene; minimum inhibitory concentration; nonhuman; priority journal; Pseudomonas aeruginosa; Salmonella; Shigella flexneri; Taiwan; clinical trial; drug effect; epidemiological monitoring; genotype; Gram negative bacterium; Gram negative infection; hospital; human; isolation and purification; microbial sensitivity test; microbiology; multicenter study; prevalence; Anti-Bacterial Agents; Carbapenems; Colistin; Drug Resistance, Bacterial; Epidemiological Monitoring; Genes, Bacterial; Genotype; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Hospitals; Humans; Microbial Sensitivity Tests; Prevalence; Taiwan |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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