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

Yu Lin Lee, Min Chi Lu, Pei Lan Shao, Po Liang Lu, Yen Hsu Chen, Shu Hsing Cheng, Wen Chien Ko, Chi Ying Lin, Ting Shu Wu, Muh Yong Yen, Lih Shinn Wang, Chang Pan Liu, Wen Sen Lee, Zhi Yuan Shi, Yao Shen Chen, Fu Der Wang, Shu Hui Tseng, Chao Nan Lin, Yu Hui Chen, Wang Huei ShengChun Ming Lee, Ming Huei Liao, Po Ren Hsueh

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)318-328
Number of pages11
JournalInternational Journal of Antimicrobial Agents
Volume54
Issue number3
DOIs
Publication statusPublished - Sep 2019

Keywords

  • Carbapenemase
  • Colistin
  • Enterobacteriaceae
  • KPC
  • mcr-1

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

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  • Cite this

    Lee, Y. L., Lu, M. C., Shao, P. L., 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., ... Hsueh, P. R. (2019). 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. International Journal of Antimicrobial Agents, 54(3), 318-328. https://doi.org/10.1016/j.ijantimicag.2019.06.009