title: Antimicrobial resistance of bacterial isolates from respiratory care wards in Taiwan: a horizontal surveillance study.
abstract: A horizontal surveillance study was conducted to identify common bacteria and mycobacteria from 611 respiratory aspirates and 165 urinary samples from 611 patients hospitalised at 17 respiratory care wards (RCWs) in Taiwan. Some major resistance phenotypes, including methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis, and multidrug-resistant Pseudomonas aeruginosa (MDR-PA) and Acinetobacter baumannii (MDR-AB), were identified. Pulsotypes of ESBL-producing P. mirabilis isolates were determined by pulsed-field gel electrophoresis. The prevalences of MRSA, ESBL-producing E. coli (K. pneumoniae and P. mirabilis), carbapenem-resistant (resistant to imipenem and meropenem) P. aeruginosa, MDR-PA, carbapenem-resistant A. baumannii and MDR-AB were, respectively, 86.7%, 20.0% (50.7% and 24.1%), 18.4%, 1.2%, 32.1% and 8.9% for respiratory aspirates and 100%, 25.4% (27.3% and 25.0%), 48.3%, 10.3%, 50.0% and 21.4% for catheterised urinary samples. Among the 44 respiratory isolates of P. mirabilis with an ESBL phenotype, 22 different pulsotypes (>80% identity) were identified. Among 103 isolates of mycobacteria, 90 (87.4%) belonged to rapidly growing mycobacteria and 4 (4%) were Mycobacterium tuberculosis. Among the 404 patients with available clinical information, true infections were found in 28.0%, the most prevalent of which were urinary tract infection (20.5%) and ventilator-associated pneumonia (10.9%). High prevalences of various multidrug-resistant bacteria among the respiratory and urinary tracts of patients present a clinical difficulty in choosing empirical antibiotic treatment in RCWs.
authors: National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors: Lu-Cheng
authors: LC
authors: Kuo
authors: Chong-Jen
authors: CJ
authors: Yu
authors: Ming-Long
authors: ML
authors: Kuo
authors: Wei-Nan
authors: WN
authors: Chen
authors: Chee-Kong
authors: CK
authors: Chang
authors: Hen-I
authors: HI
authors: Lin
authors: Chih-Chiang
authors: CC
authors: Chen
authors: Min-Chi
authors: MC
authors: Lu
authors: Ching-Hsiung
authors: CH
authors: Lin
authors: Wu-Feng
authors: WF
authors: Hsieh
authors: Liang-Wu
authors: LW
authors: Chen
authors: Yih
authors: Y
authors: Chou
authors: Ming-Shian
authors: MS
authors: Huang
authors: Cheng-Hsiung
authors: CH
authors: Lee
authors: Shen-Chun
authors: SC
authors: Chen
authors: Sun-Lung
authors: SL
authors: Thai
authors: Po-Chung
authors: PC
authors: Chen
authors: Ching-Hsiung
authors: CH
authors: Chen
authors: Chung-Chia
authors: CC
authors: Tseng
authors: Yao-Shen
authors: YS
authors: Chen
authors: Tzuen-Ren
authors: TR
authors: Hsiue
authors: Po-Ren
authors: PR
authors: Hsueh
mesh_terms: D015373:Bacterial Typing Techniques; D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D006094:Gram-Positive Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007297:Inpatients; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D013624:Taiwan / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D004269:DNA, Bacterial