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
Journal
International Journal of Antimicrobial Agents
Journal Volume
54
Journal Issue
3
Pages
318-328
Date Issued
2019
Author(s)
Lee Y.-L.
Lu M.-C.
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.
Lee C.-M.
Liao M.-H.
Abstract
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
SDGs
Other Subjects
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
Type
journal article