title: Antimicrobial susceptibility profiles of Gram-negative bacilli isolated from patients with hepatobiliary infections in Taiwan: results from the Study for Monitoring Antimicrobial Resistance Trends (SMART), 2006-2010.
abstract: We investigated the trends in antimicrobial resistance among species of Gram-negative bacilli isolated from patients with hepatobiliary tract infections in Taiwan during the period 2006-2010 as part of the Study for Monitoring Antimicrobial Resistance Trends (SMART). During the study period, 1032 isolates of Gram-negative bacilli that had been collected from patients with hepatobiliary infections were tested for susceptibility to 12 antimicrobial agents in accordance with the Clinical and Laboratory Standards Institute guidelines. Enterobacteriaceae accounted for the majority (n = 874, 84.7%) of isolates and Escherichia coli was the most common pathogen (n = 323, 31.3%). There were significantly more E. coli (P = 0.001) and Proteus mirabilis (P = 0.031) isolates collected from patients who had been hospitalized for less than 48 h and significantly more Serratia marcescens (P = 0.035) and Pseudomonas aeruginosa (P = 0.008) isolates collected from patients who had been hospitalized for 48 h or longer. The prevalence of extended-spectrum β-lactamase (ESBL)-producing pathogens was low. The decline in susceptibility rates with time was remarkable for ceftazidime (P = 0.036), ciprofloxacin (P = 0.029), and levofloxacin (P = 0.018). The most effective antibiotics, i.e., those that were active against more than 90% of Enterobacteriaceae, were amikacin, cefepime, imipenem, ertapenem, and piperacillin-tazobactam. Susceptibility of P. aeruginosa to anti-pseudomonal agents was greater than 80%. In this study, we found an overall increase in resistance to antimicrobial agents among Gram-negative bacilli isolated from patients with hepatobiliary tract infections in Taiwan. Surveillance of antimicrobial susceptibility and updates of treatment guidelines are recommended to help achieve optimal therapy for patients with hepatobiliary infections.
authors: Department of Infectious Diseases, Chi Mei Medical Center, Tainan City, Taiwan.
authors: Han-Siong
authors: HS
authors: Toh
authors: Yin-Ching
authors: YC
authors: Chuang
authors: Chi-Chang
authors: CC
authors: Huang
authors: Yu-Lin
authors: YL
authors: Lee
authors: Yuag-Meng
authors: YM
authors: Liu
authors: Cheng-Mao
authors: CM
authors: Ho
authors: Po-Liang
authors: PL
authors: Lu
authors: Chun-Eng
authors: CE
authors: Liu
authors: Yen-Hsu
authors: YH
authors: Chen
authors: Jen-Hsien
authors: JH
authors: Wang
authors: Wen-Chien
authors: WC
authors: Ko
authors: Kwok-Woon
authors: KW
authors: Yu
authors: Yung-Ching
authors: YC
authors: Liu
authors: Yao-Shen
authors: YS
authors: Chen
authors: Hung-Jen
authors: HJ
authors: Tang
authors: Po-Ren
authors: PR
authors: Hsueh
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002442:Ceftazidime / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology; D005705:Gallbladder Diseases / Q000453:epidemiology / Q000382:microbiology*; D006760:Hospitalization; D006801:Humans; D064704:Levofloxacin; D008107:Liver Diseases / Q000453:epidemiology / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D015242:Ofloxacin / Q000494:pharmacology; D011159:Population Surveillance / Q000379:methods; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D064704:Levofloxacin; D002442:Ceftazidime; D015242:Ofloxacin; D001618:beta-Lactamases