Antimicrobial resistance of bacterial isolates from respiratory care wards in Taiwan: a horizontal surveillance study.
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.
Kuo
Lu-Cheng
LC
National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Yu
Chong-Jen
CJ
Kuo
Ming-Long
ML
Chen
Wei-Nan
WN
Chang
Chee-Kong
CK
Lin
Hen-I
HI
Chen
Chih-Chiang
CC
Lu
Min-Chi
MC
Lin
Ching-Hsiung
CH
Hsieh
Wu-Feng
WF
Chen
Liang-Wu
LW
Chou
Yih
Y
Huang
Ming-Shian
MS
Lee
Cheng-Hsiung
CH
Chen
Shen-Chun
SC
Thai
Sun-Lung
SL
Chen
Po-Chung
PC
Chen
Ching-Hsiung
CH
Tseng
Chung-Chia
CC
Chen
Yao-Shen
YS
Hsiue
Tzuen-Ren
TR
Hsueh
Po-Ren
PR
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*
D004269:DNA, Bacterial