國家衛生研究院 NHRI:Item 3990099045/9457

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Title:	Antimicrobial non-susceptibility of escherichia coli from outpatients and patients visiting emergency rooms in Taiwan
Authors:	Wang, JT;Chang, SC;Chang, FY;Fung, CP;Chuang, YC;Chen, YS;Shiau, YR;Tan, MC;Wang, HY;Lai, JF;Huang, IW;Yang, LTL
Contributors:	Division of Infectious Diseases
Abstract:	Longitudinal nationwide surveillance data on antimicrobial non-susceptibility and prevalence of extended-spectrum beta-lactamases (ESBLs) as well as AmpC beta-lactamases producers among Escherichia coli from different sources in the community settings are limited. Such data may impact treatment practice. The present study investigated E. coli from outpatients and patients visiting emergency rooms collected by the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program. A total of 3481 E. coli isolates were studied, including 2153 (61.9%) from urine and 1125 (32.3%) from blood samples. These isolates were collected biennially between 2002 and 2012 from a total of 28 hospitals located in different geographic regions of Taiwan. Minimum inhibitory concentrations (MIC) were determined using methods recommended by the Clinical Laboratory Standards Institute (CLSI). The prevalence and factors associated with the presence of ESBL and AmpC beta-lactamase-producers were determined. Significant increases in non-susceptibility to most beta-lactams and ciprofloxacin occurred during the study period. By 2012, non-susceptibility to cefotaxime and ciprofloxacin reached 21.1% and 26.9%, respectively. The prevalence of ESBL- and AmpC- producers also increased from 4.0% and 5.3%, respectively, in 2002-2004, to 10.7% for both in 2010-2012 (P < 0.001). The predominant ESBL and AmpC beta-lactamase genes were CTX-M and CMY-types, respectively. Non-susceptibility of urine isolates to nitrofurantoin remained at around 8% and to fosfomycin was low (0.7%) but to cefazolin (based on the 2014 CLSI urine criteria) increased from 11.5% in 2002-2004 to 23.9% in 2010-2012 (P <0.001). Non-susceptibility of isolates from different specimen types was generally similar, but isolates from elderly patients were significantly more resistant to most antimicrobial agents and associated with the presence of ESBL- and AmpC- beta-lactamases. An additional concern is that decreased ciprofloxacin susceptibility (MIC 0.12-1 mg/L) was as high as 25% in isolates from all age groups, including those from pediatric patients. Our data indicated that there is a need to re-evaluate appropriate treatment selection for community-acquired infections in Taiwan. Identification of community reservoirs of multidrug-resistant E. coli is also warranted.
Date:	2015-12-03
Relation:	PLoS ONE. 2015 Dec 3;10(12):Article number e0144103.
Link to:	http://dx.doi.org/10.1371/journal.pone.0144103
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1932-6203&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:000366040000056
Cited Times(Scopus):	http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84956625938
Appears in Collections:	[Tsai-Ling Yang Lauderdale] Periodical Articles

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