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.
Int J Antimicrob Agents
; 54(3): 318-328, 2019 Sep.
Article
en En
| MEDLINE
| ID: mdl-31202925
ABSTRACT
Multicentre surveillance of antimicrobial susceptibility of clinically important Gram-negative bacteria (GNB) from 16 Taiwanese hospitals was performed. Escherichia coli (nâ¯=â¯398), Klebsiella pneumoniae (nâ¯=â¯346), Pseudomonas aeruginosa (nâ¯=â¯252) and Acinetobacter baumannii complex (ABC) (nâ¯=â¯188) bloodstream isolates, non-typhoidal Salmonella (nâ¯=â¯230) and Shigella flexneri (nâ¯=â¯18) from various sources were collected. Antimicrobial MICs were determined using broth microdilution. Genes encoding K. pneumoniae carbapenemases (KPCs), New Delhi metallo-ß-lactamases (NDMs), Verona integron-encoded metallo-ß-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.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Carbapenémicos
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Infecciones por Bacterias Gramnegativas
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Colistina
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Farmacorresistencia Bacteriana
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Monitoreo Epidemiológico
/
Bacterias Gramnegativas
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Antibacterianos
Tipo de estudio:
Clinical_trials
/
Prevalence_studies
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Risk_factors_studies
/
Screening_studies
Límite:
Humans
País/Región como asunto:
Asia
Idioma:
En
Revista:
Int J Antimicrob Agents
Año:
2019
Tipo del documento:
Article
País de afiliación:
Taiwán