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)

doi:10.2147/IDR.S194482

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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)
Authors:	Lai, Chih-Cheng Chen, Ying-Sheng Lee, Nan-Yao Hung-Jen Tang(湯宏仁) Lee, Susan Shin-Jung Lin, Chin-Fu Lu, Po-Liang Wu, Jiunn-Jong Ko, Wen-Chien Lee, Wen-Sen Hsueh, Po-Ren
Contributors:	Chi Mei Med Ctr, Dept Intens Care Med Cardinal Tien Hosp, Dept Internal Med, Div Infect Dis Natl Cheng Kung Univ, Dept Internal Med, Med Coll & Hosp Chi Mei Med Ctr, Dept Internal Med Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Kaohsiung Vet Gen Hosp, Dept Internal Med Natl Yang Ming Univ, Fac Med, Sch Med Taichung Vet Gen Hosp, Dept Pathol & Lab Med Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Coll Med, Dept Internal Med Kaohsiung Med Univ Hosp, Dept Lab Med Kaohsiung Med Univ, Grad Inst Med, Coll Med Natl Yang Ming Univ, Dept Biotechnol Natl Yang Ming Univ, Lab Sci Med Natl Cheng Kung Univ, Dept Med, Coll Med Taipei Med Univ, Dept Internal Med, Div Infect Dis, Wan Fang Med Ctr Natl Taiwan Univ, Dept Lab Med, Natl Taiwan Univ Hosp, Coll Med Natl Taiwan Univ, Dept Internal Med, Natl Taiwan Univ Hosp, Coll Med
Keywords:	colistin carbapenems susceptibility carbapenemase mcr-1 intensive care units SMART P. aeruginosa A. baumannii
Date:	2019
Issue Date:	2020-07-29 13:49:42 (UTC+8)
Publisher:	DOVE MEDICAL PRESS LTD
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 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.
Relation:	Infection and Drug Resistance, v.12, pp.627-640
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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