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 Sheng; Chun Ming Lee; Ming Huei Liao; Po Ren Hsueh

doi:10.1016/j.ijantimicag.2019.06.009

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 journal › Article › peer-review

44 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 bla_NDM-1. Fifteen (4.3%), two (0.6%) and two (0.6%) K. pneumoniae contained bla_KPC, bla_OXA-48 and bla_VIM, 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. bla_KPC, especially the bla_KPC-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 language	English
Pages (from-to)	318-328
Number of pages	11
Journal	International Journal of Antimicrobial Agents
Volume	54
Issue number	3
DOIs	https://doi.org/10.1016/j.ijantimicag.2019.06.009
Publication status	Published - Sept 2019

Keywords

Carbapenemase
Colistin
Enterobacteriaceae
KPC
mcr-1

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases
Pharmacology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ijantimicag.2019.06.009

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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

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. / Lee, Yu Lin; Lu, Min Chi; Shao, Pei Lan et al.
In: International Journal of Antimicrobial Agents, Vol. 54, No. 3, 09.2019, p. 318-328.

Research output: Contribution to journal › Article › peer-review

Lee, YL, Lu, MC, Shao, PL, Lu, PL, Chen, YH, Cheng, SH, Ko, WC, Lin, CY, Wu, TS, Yen, MY, Wang, LS, Liu, CP, Lee, WS, Shi, ZY, Chen, YS, Wang, FD, Tseng, SH, Lin, CN, Chen, YH, Sheng, WH, Lee, CM, Liao, MH & Hsueh, PR 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, vol. 54, no. 3, pp. 318-328. https://doi.org/10.1016/j.ijantimicag.2019.06.009

Lee YL, Lu MC, Shao PL, Lu PL, Chen YH, Cheng SH et al. 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. 2019 Sept;54(3):318-328. doi: 10.1016/j.ijantimicag.2019.06.009

Lee, Yu Lin ; Lu, Min Chi ; Shao, Pei Lan et al. / 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. In: International Journal of Antimicrobial Agents. 2019 ; Vol. 54, No. 3. pp. 318-328.

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title = "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",

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.",

keywords = "Carbapenemase, Colistin, Enterobacteriaceae, KPC, mcr-1",

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

note = "Publisher Copyright: {\textcopyright} 2019",

year = "2019",

month = sep,

doi = "10.1016/j.ijantimicag.2019.06.009",

language = "English",

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T2 - Results from the Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART) in 2018

AU - Lee, Yu Lin

AU - Lu, Min Chi

AU - Shao, Pei Lan

AU - Lu, Po Liang

AU - Chen, Yen Hsu

AU - Cheng, Shu Hsing

AU - Ko, Wen Chien

AU - Lin, Chi Ying

AU - Wu, Ting Shu

AU - Yen, Muh Yong

AU - Wang, Lih Shinn

AU - Liu, Chang Pan

AU - Lee, Wen Sen

AU - Shi, Zhi Yuan

AU - Chen, Yao Shen

AU - Wang, Fu Der

AU - Tseng, Shu Hui

AU - Lin, Chao Nan

AU - Chen, Yu Hui

AU - Sheng, Wang Huei

AU - Lee, Chun Ming

AU - Liao, Ming Huei

AU - Hsueh, Po Ren

PY - 2019/9

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N2 - 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.

AB - 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.

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KW - mcr-1

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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

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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