https://scholars.lib.ntu.edu.tw/handle/123456789/535780
標題: | Antimicrobial susceptibilities of Proteus mirabilis: A longitudinal nationwide study from the Taiwan surveillance of antimicrobial resistance (TSAR) program | 作者: | JANN-TAY WANG Chen P.-C. SHAN-CHWEN CHANG Shiau Y.-R. Wang H.-Y. Lai J.-F. Huang I.-W. Tan M.-C. Lauderdale T.-L.Y. TSAR Hospitals |
公開日期: | 2014 | 出版社: | BioMed Central Ltd. | 卷: | 14 | 期: | 1 | 起(迄)頁: | 486 | 來源出版物: | BMC Infectious Diseases | 摘要: | Background: Longitudinal nationwide data on antimicrobial susceptibility in Proteus mirabilis from different sources are rare. The effects of the revised Clinical and Laboratory Standards Institute (CLSI) β-lactam breakpoints on susceptibility rates and on detecting extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase-producers in this species are also seldom evaluated. The present study analyzed data from the Taiwan Surveillance of Antimicrobial Resistance program to address these issues.Methods: Isolates were collected biennially between 2002 and 2012 from 25 to 28 hospitals in Taiwan. Minimum inhibitory concentrations (MIC) were determined by reference broth microdilution method. All isolates with aztreonam, ceftazidime, or cefotaxime MIC ? 2 mg/L were checked for the presence of ESBL by CLSI confirmatory test and subjected to ESBL and AmpC β-lactamases gene detection by PCR. Univariate and multivariate analyses were performed.Results: Between 2002 and 2012, a total of 1157 P. mirabilis were studied. Susceptibility to cefotaxime, ceftazidime, and ciprofloxacin decreased significantly during the past decade, from 92.6% to 81.7%, 100% to 95.2%, and 80.1% to 53.8%, respectively (P < 0.01). The revised CLSI breakpoints had significant impact on susceptibility to cefazolin (2009 vs. current breakpoints, 71.9% vs. 0.9%) and imipenem (99.8% vs. 55.1%) (P < 0.001 for both). However, using the 2014 cefazolin breakpoints for urinary tract infections, 81.2% of the urine isolates were susceptible. Susceptibilities of isolates from different specimen types were mostly similar but outpatient isolates were more susceptible than inpatient isolates. The overall prevalence of ESBL- and AmpC- producers was 8.2% and 4.7%, respectively, but AmpC carriage increased significantly over the years (from 0 to 7.0%, P < 0.001). ESBL and AmpC β-lactamase-producers were more likely to be found in elderly and ICU patients. The predominant ESBL and AmpC β-lactamase genes were CTX-M- and CMY- types, respectively.Conclusions: A significant decrease in susceptibility to 3rd-generation cephalosporins and ciprofloxacin occurred in P. mirabilis from Taiwan in the past decade. The prevalence of ESBL remained stable but AmpC β-lactamase-producing P. mirabilis increased significantly. Cefotaxime was a better surrogate than ceftazidime for predicting the presence of these β-lactamases. Continuous surveillance on antimicrobial resistance and associated resistance mechanisms in P. mirabilis is warranted. ? 2014 Wang et al.; licensee BioMed Central Ltd. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84906929482&doi=10.1186%2f1471-2334-14-486&partnerID=40&md5=56695d29f6d21c6dd44fa190674a9485 https://scholars.lib.ntu.edu.tw/handle/123456789/535780 |
ISSN: | 1471-2334 | DOI: | 10.1186/1471-2334-14-486 | SDG/關鍵字: | amikacin; amoxicillin; amoxicillin plus clavulanic acid; ampicillin; antibiotic agent; aztreonam; beta lactamase; beta lactamase AmpC; beta lactamase CMY; beta lactamase CTX M; cefazolin; cefepime; cefotaxime; cefoxitin; ceftazidime; cefuroxime; ciprofloxacin; cotrimoxazole; ertapenem; extended spectrum beta lactamase; gentamicin; imipenem; meropenem; nitrofurantoin; piperacillin; unclassified drug; AmpC beta-lactamases; antiinfective agent; aztreonam; bacterial protein; beta lactam; cefotaxime; ceftazidime; adolescent; adult; aged; antibiotic resistance; antibiotic sensitivity; Article; bacterium isolate; broth dilution; enzyme synthesis; gene identification; hospital patient; human; longitudinal study; major clinical study; middle aged; minimum inhibitory concentration; nonhuman; outpatient; polymerase chain reaction; prediction; prevalence; Proteus mirabilis; Taiwan; urinary tract infection; young adult; antibiotic resistance; child; drug effects; female; genetics; health survey; isolation and purification; male; microbial sensitivity test; microbiology; preschool child; Proteus Infections; Proteus mirabilis; Urinary Tract Infections; very elderly; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Aztreonam; Bacterial Proteins; beta-Lactamases; beta-Lactams; Cefotaxime; Ceftazidime; Child; Child, Preschool; Drug Resistance, Bacterial; Female; Humans; Longitudinal Studies; Male; Microbial Sensitivity Tests; Middle Aged; Population Surveillance; Proteus Infections; Proteus mirabilis; Taiwan; Urinary Tract Infections; Young Adult |
顯示於: | 醫學系 |
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