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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)627-640
Number of pages14
JournalInfection and Drug Resistance
Volume12
DOIs
Publication statusPublished - 2019 Jan 1

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Colistin
Carbapenems
Taiwan
Intensive Care Units
Bacteria
Enterobacter cloacae
Acinetobacter baumannii
Klebsiella pneumoniae
Microbial Sensitivity Tests
Bacillus
Enterobacteriaceae
Pseudomonas aeruginosa
Morganella morganii
Proteus mirabilis
Genes

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

@article{e79db74e78c741eb9c53a83070888c47,
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.",
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}",
year = "2019",
month = "1",
day = "1",
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.",

}

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; Tang, Hung Jen; Lee, Susan Shin Jung; Lin, Chin Fu; Lu, Po Liang; Wu, Jiunn Jong; Ko, Wen Chien; Lee, Wen Sen; Hsueh, Po Ren.

In: Infection and Drug Resistance, Vol. 12, 01.01.2019, p. 627-640.

Research output: Contribution to journalArticle

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 - 2019/1/1

Y1 - 2019/1/1

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.

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JO - Infection and Drug Resistance

JF - Infection and Drug Resistance

SN - 1178-6973

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