Susceptibility rates of clinically important bacteria collected from intensive care units against colistin, carbapenems, and other comparative agents: Results from surveillance of multicenter antimicrobial resistance in Taiwan (SMART)

Chih Cheng Lai; Ying Sheng Chen; Nan Yao Lee; Hung Jen Tang; Susan Shin Jung Lee; Chin Fu Lin; Po Liang Lu; Jiunn Jong Wu; Wen Chien Ko; Wen Sen Lee; Po Ren Hsueh

doi:10.2147/idr.s194482

Susceptibility rates of clinically important bacteria collected from intensive care units against colistin, carbapenems, and other comparative agents: Results from surveillance of multicenter antimicrobial resistance in Taiwan (SMART)

Chih Cheng Lai, Ying Sheng Chen, Nan Yao Lee, Hung Jen Tang, Susan Shin Jung Lee, Chin Fu Lin, Po Liang Lu, Jiunn Jong Wu, Wen Chien Ko, Wen Sen Lee, Po Ren Hsueh^*

^*此作品的通信作者

研究成果: Article › 同行評審

26 引文斯高帕斯（Scopus）

摘要

Objectives: This study aimed to determine the in vitro susceptibility of commonly encountered Gram-negative bacilli (GNB) recovered from patients admitted to intensive care units (ICUs) in Taiwan against colistin, carbapenems, and other comparative agents. Methods: In total, 758 nonduplicate GNB isolates were obtained from clinical specimens of ICU patients at seven medical centers in 2016. Minimum inhibitory concentrations (MICs) were determined using the Vitek 2 susceptibility system. The reference broth-microdilution method was performed to determine MICs of colistin. Five main carbapenemase genes among carbapenem-non-susceptible GNB and mcr-1–mcr5 genes among colistin non-wild-type or-resistant isolates were determined. Results: After exclusion 38 Proteus mirabilis and 13 Morganella morganii spp. among 361 Enterobacteriaceae isolates, 34 (9.4%) isolates were carbapenem-insusceptible, 91.1% (n=31) were colistin wild type, and three and one Klebsiella pneumoniae isolates carried bla_KPC and bla_OXA48-like, respectively. Carbapenem-insusceptible isolates were found in 23.4% (30 of 128) and 63.0% (87 of 138) of isolates of the Pseudomonas aeruginosa and Acinetobacter baumannii complex, respectively. mcr-1 was detected in two (1.8%) Enterobacter cloacae isolates. Very major errors between two methods of susceptibility to colistin were found in 1.5% of K. pneumoniae, 27.5% of E. cloacae, 4.7% of P. aeruginosa, and 10.1% of A. baumannii complex isolates. Conclusion: In this study, 8.7% of Enterobacteriaceae isolates from ICUs were not susceptible to carbapenem, and bla_KPC and bla_OXA48-like were found among three and one carbapenem-insusceptible K. pneumoniae isolates, respectively. Colistin MICs determined by Vitek 2 were not reliable, especially for E. cloacae and A. baumannii complex isolates.

原文	English
頁（從 - 到）	627-640
頁數	14
期刊	Infection and Drug Resistance
卷	12
DOIs	https://doi.org/10.2147/idr.s194482
出版狀態	Published - 2019

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Lai, C. C., Chen, Y. S., Lee, N. Y., Tang, H. J., Lee, S. S. J., Lin, C. F., Lu, P. L., Wu, J. J., Ko, W. C., Lee, W. S., & Hsueh, P. R. (2019). Susceptibility rates of clinically important bacteria collected from intensive care units against colistin, carbapenems, and other comparative agents: Results from surveillance of multicenter antimicrobial resistance in Taiwan (SMART). Infection and Drug Resistance, 12, 627-640. https://doi.org/10.2147/idr.s194482

@article{a0b119c416a540559d72c1b37db7ec67,

title = "Susceptibility rates of clinically important bacteria collected from intensive care units against colistin, carbapenems, and other comparative agents: Results from surveillance of multicenter antimicrobial resistance in Taiwan (SMART)",

abstract = "Objectives: This study aimed to determine the in vitro susceptibility of commonly encountered Gram-negative bacilli (GNB) recovered from patients admitted to intensive care units (ICUs) in Taiwan against colistin, carbapenems, and other comparative agents. Methods: In total, 758 nonduplicate GNB isolates were obtained from clinical specimens of ICU patients at seven medical centers in 2016. Minimum inhibitory concentrations (MICs) were determined using the Vitek 2 susceptibility system. The reference broth-microdilution method was performed to determine MICs of colistin. Five main carbapenemase genes among carbapenem-non-susceptible GNB and mcr-1–mcr5 genes among colistin non-wild-type or-resistant isolates were determined. Results: After exclusion 38 Proteus mirabilis and 13 Morganella morganii spp. among 361 Enterobacteriaceae isolates, 34 (9.4%) isolates were carbapenem-insusceptible, 91.1% (n=31) were colistin wild type, and three and one Klebsiella pneumoniae isolates carried blaKPC and blaOXA48-like, respectively. Carbapenem-insusceptible isolates were found in 23.4% (30 of 128) and 63.0% (87 of 138) of isolates of the Pseudomonas aeruginosa and Acinetobacter baumannii complex, respectively. mcr-1 was detected in two (1.8%) Enterobacter cloacae isolates. Very major errors between two methods of susceptibility to colistin were found in 1.5% of K. pneumoniae, 27.5% of E. cloacae, 4.7% of P. aeruginosa, and 10.1% of A. baumannii complex isolates. Conclusion: In this study, 8.7% of Enterobacteriaceae isolates from ICUs were not susceptible to carbapenem, and blaKPC and blaOXA48-like were found among three and one carbapenem-insusceptible K. pneumoniae isolates, respectively. Colistin MICs determined by Vitek 2 were not reliable, especially for E. cloacae and A. baumannii complex isolates.",

keywords = "A. Baumannii, Carbapenemase, Carbapenems, Colistin, Intensive care units, Mcr-1, P. Aeruginosa, SMART, Susceptibility",

author = "Lai, {Chih Cheng} and Chen, {Ying Sheng} and Lee, {Nan Yao} and Tang, {Hung Jen} and Lee, {Susan Shin Jung} and Lin, {Chin Fu} and Lu, {Po Liang} and Wu, {Jiunn Jong} and Ko, {Wen Chien} and Lee, {Wen Sen} and Hsueh, {Po Ren}",

note = "Publisher Copyright: {\textcopyright} 2019 Lai et al.",

year = "2019",

doi = "10.2147/idr.s194482",

language = "English",

volume = "12",

pages = "627--640",

journal = "Infection and Drug Resistance",

issn = "1178-6973",

publisher = "Dove Medical Press Ltd.",

}

Lai, CC, Chen, YS, Lee, NY, Tang, HJ, Lee, SSJ, Lin, CF, Lu, PL, Wu, JJ, Ko, WC, Lee, WS & Hsueh, PR 2019, 'Susceptibility rates of clinically important bacteria collected from intensive care units against colistin, carbapenems, and other comparative agents: Results from surveillance of multicenter antimicrobial resistance in Taiwan (SMART)', Infection and Drug Resistance, 卷 12, 頁 627-640. https://doi.org/10.2147/idr.s194482

Susceptibility rates of clinically important bacteria collected from intensive care units against colistin, carbapenems, and other comparative agents: Results from surveillance of multicenter antimicrobial resistance in Taiwan (SMART). / Lai, Chih Cheng; Chen, Ying Sheng; Lee, Nan Yao 等.
於: Infection and Drug Resistance, 卷 12, 2019, p. 627-640.

研究成果: Article › 同行評審

TY - JOUR

T1 - Susceptibility rates of clinically important bacteria collected from intensive care units against colistin, carbapenems, and other comparative agents

T2 - Results from surveillance of multicenter antimicrobial resistance in Taiwan (SMART)

AU - Lai, Chih Cheng

AU - Chen, Ying Sheng

AU - Lee, Nan Yao

AU - Tang, Hung Jen

AU - Lee, Susan Shin Jung

AU - Lin, Chin Fu

AU - Lu, Po Liang

AU - Wu, Jiunn Jong

AU - Ko, Wen Chien

AU - Lee, Wen Sen

AU - Hsueh, Po Ren

PY - 2019

Y1 - 2019

N2 - Objectives: This study aimed to determine the in vitro susceptibility of commonly encountered Gram-negative bacilli (GNB) recovered from patients admitted to intensive care units (ICUs) in Taiwan against colistin, carbapenems, and other comparative agents. Methods: In total, 758 nonduplicate GNB isolates were obtained from clinical specimens of ICU patients at seven medical centers in 2016. Minimum inhibitory concentrations (MICs) were determined using the Vitek 2 susceptibility system. The reference broth-microdilution method was performed to determine MICs of colistin. Five main carbapenemase genes among carbapenem-non-susceptible GNB and mcr-1–mcr5 genes among colistin non-wild-type or-resistant isolates were determined. Results: After exclusion 38 Proteus mirabilis and 13 Morganella morganii spp. among 361 Enterobacteriaceae isolates, 34 (9.4%) isolates were carbapenem-insusceptible, 91.1% (n=31) were colistin wild type, and three and one Klebsiella pneumoniae isolates carried blaKPC and blaOXA48-like, respectively. Carbapenem-insusceptible isolates were found in 23.4% (30 of 128) and 63.0% (87 of 138) of isolates of the Pseudomonas aeruginosa and Acinetobacter baumannii complex, respectively. mcr-1 was detected in two (1.8%) Enterobacter cloacae isolates. Very major errors between two methods of susceptibility to colistin were found in 1.5% of K. pneumoniae, 27.5% of E. cloacae, 4.7% of P. aeruginosa, and 10.1% of A. baumannii complex isolates. Conclusion: In this study, 8.7% of Enterobacteriaceae isolates from ICUs were not susceptible to carbapenem, and blaKPC and blaOXA48-like were found among three and one carbapenem-insusceptible K. pneumoniae isolates, respectively. Colistin MICs determined by Vitek 2 were not reliable, especially for E. cloacae and A. baumannii complex isolates.

AB - Objectives: This study aimed to determine the in vitro susceptibility of commonly encountered Gram-negative bacilli (GNB) recovered from patients admitted to intensive care units (ICUs) in Taiwan against colistin, carbapenems, and other comparative agents. Methods: In total, 758 nonduplicate GNB isolates were obtained from clinical specimens of ICU patients at seven medical centers in 2016. Minimum inhibitory concentrations (MICs) were determined using the Vitek 2 susceptibility system. The reference broth-microdilution method was performed to determine MICs of colistin. Five main carbapenemase genes among carbapenem-non-susceptible GNB and mcr-1–mcr5 genes among colistin non-wild-type or-resistant isolates were determined. Results: After exclusion 38 Proteus mirabilis and 13 Morganella morganii spp. among 361 Enterobacteriaceae isolates, 34 (9.4%) isolates were carbapenem-insusceptible, 91.1% (n=31) were colistin wild type, and three and one Klebsiella pneumoniae isolates carried blaKPC and blaOXA48-like, respectively. Carbapenem-insusceptible isolates were found in 23.4% (30 of 128) and 63.0% (87 of 138) of isolates of the Pseudomonas aeruginosa and Acinetobacter baumannii complex, respectively. mcr-1 was detected in two (1.8%) Enterobacter cloacae isolates. Very major errors between two methods of susceptibility to colistin were found in 1.5% of K. pneumoniae, 27.5% of E. cloacae, 4.7% of P. aeruginosa, and 10.1% of A. baumannii complex isolates. Conclusion: In this study, 8.7% of Enterobacteriaceae isolates from ICUs were not susceptible to carbapenem, and blaKPC and blaOXA48-like were found among three and one carbapenem-insusceptible K. pneumoniae isolates, respectively. Colistin MICs determined by Vitek 2 were not reliable, especially for E. cloacae and A. baumannii complex isolates.

KW - A. Baumannii

KW - Carbapenemase

KW - Carbapenems

KW - Colistin

KW - Intensive care units

KW - Mcr-1

KW - P. Aeruginosa

KW - SMART

KW - Susceptibility

UR - http://www.scopus.com/inward/record.url?scp=85064601143&partnerID=8YFLogxK

U2 - 10.2147/idr.s194482

DO - 10.2147/idr.s194482

M3 - Article

AN - SCOPUS:85064601143

SN - 1178-6973

VL - 12

SP - 627

EP - 640

JO - Infection and Drug Resistance

JF - Infection and Drug Resistance

ER -