Chia Nan University of Pharmacy & Science Institutional Repository:Item 310902800/27632
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    標題: Antimicrobial susceptibility of pathogens isolated from patients with complicated intra-abdominal infections at five medical centers in Taiwan that continuously participated in the Study for Monitoring Antimicrobial Resistance Trends (SMART) from 2006 to 2010
    作者: Lee, Yu-Lin
    Chen, Yao-Shen
    Toh, Han-Siong
    Huang, Chi-Chang
    Liu, Yuag-Meng
    Ho, Cheng-Mao
    Lu, Po-Liang
    Ko, Wen-Chien
    Chen, Yen-Hsu
    Wang, Jen-Hsien
    Tang, Hung-Jen
    Yu, Kwok-Woon
    Liu, Yung-Ching
    Chuang, Yin-Ching
    Liu, Chun-Eng
    Hsueh, Po-Ren
    貢獻者: 保健營養系
    關鍵字: Antimicrobial Resistance
    Epidemiology
    Enterobacteriaceae
    Extended-Spectrum Beta-Lactamase
    Taiwan
    日期: 2012-06
    上傳時間: 2014-03-21 16:15:53 (UTC+8)
    出版者: Elsevier Science Bv
    摘要: The Study for Monitoring Antimicrobial Resistance Trends (SMART) is a worldwide surveillance program designed to longitudinally monitor the in vitro activity of antimicrobial agents against pathogens that cause intra-abdominal infections (IAIs). In this study, trends in antimicrobial resistance during the period 2006 to 2010 were analyzed at five tertiary-care hospitals in Taiwan. Enterobacteriaceae accounted for the majority (80.9%) of the 2417 Gram-negative isolates, and the two most common species were Escherichia coli (38.8%) and Klebsiella pneumoniae (23.5%). The rates of susceptibility of Enterobacteriaceae isolates to cephalosporins decreased during the study period. Although carbapenems, fluoroquinolones, piperacillin-tazobactam, and amikacin were active in vitro against more than 80% of the Enterobacteriaceae isolates, the activity of carbapenems declined during the study period. Extended-spectrum beta-lactamase (ESBL) production in E. coli was steady, but that in K. pneumoniae decreased during the study period. The rate of ESBL-producing species was three-fold higher among patients with nosocomial IAIs than among patients with community-acquired IAIs. The majority of isolates from liver were K. pneumoniae (69%) and very few of those isolates were ESBL producers (0.9%). Pseudomonas aeruginosa (9.3%) and Acinetobacter baumannii (3.8%) were the two most common non-Enterobacteriaceae. P. aeruginosa showed improved susceptibility, whereas A. baumannii showed a rapid development of resistance during the study period. There was marked geographic variation in resistance patterns of the isolates obtained during the study period. Northern Taiwan had the highest rate of ESBL producers and the highest rate of ceftazidime resistance among P. aeruginosa isolates. Central Taiwan had the lowest rate of ESBL producers but the highest rates of carbapenem resistance among P. aeruginosa and A. baumannii isolates. Continuous monitoring and regular updates of epidemiological data are needed to guide appropriate empiric antimicrobial therapy. (C) 2012 Elsevier B. V. and the International Society of Chemotherapy. All rights reserved.
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