title: Rates of susceptibility of carbapenems, ceftobiprole, and colistin against clinically important bacteria collected from intensive care units in 2007: Results from the Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART).
abstract: BACKGROUND
  Data on susceptibility to ceftobiprole and colistin, and the complete evolutionary trends of minimum inhibitory concentrations (MICs) of important carbapenem agents among important pathogens collected in intensive care units (ICUs) in Taiwan are lacking.
  
  
  METHODS
  We surveyed the MIC distribution patterns of ceftobiprole and colistin and susceptibility profiles of some important pathogens collected from patients hospitalized in intensive care units (ICUs) of major teaching hospitals throughout Taiwan in 2007. We also investigated the rates of nonsusceptibility to powerful carbapenems (imipenem, meropenem) among four important species of Enterobacteriaceae (Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Proteus mirabilis) collected during the same period. MIC breakpoints recommended by the Clinical and Laboratory Standards Institute in 2014 were applied.
  
  
  RESULTS
  Colistin showed excellent in vitro activity (susceptibility rate, 96%) against Acinetobacter baumannii isolates but moderate (73-77% susceptibility rate) activity against isolates of Pseudomonas aeruginosa and E. cloacae. The ceftobiprole MIC90value was 4 μg/mL for methicillin-resistant Staphylococcus aureus and 16 μg/mL for P. aeruginosa. The phenotype of methicillin resistance did not markedly increase the MIC value of ceftobiprole among S. aureus isolates. Interestingly, the proportion of isolates that displayed nonsusceptibility to imipenem was significantly higher among P. mirabilis isolates than among isolates of the other three Enterobacteriaceae species, regardless of the production of extended-spectrum β-lactamase.
  
  
  CONCLUSIONS
  Continuous monitoring of susceptibility profiles of ICU pathogens to important antibiotics is warranted to provide appropriate antimicrobial regimens against infections in the ICU.
authors: Emergency Department, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors: Shio-Shin
authors: SS
authors: Jean
authors: Division of Infectious Diseases, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors: Wen-Sen
authors: WS
authors: Lee
authors: Department of Internal Medicine, Pathology and Laboratory Medicine, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan.
authors: Kwok-Woon
authors: KW
authors: Yu
authors: Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors: Chun-Hsing
authors: CH
authors: Liao
authors: Emergency Department, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors: Chin-Wang
authors: CW
authors: Hsu
authors: Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center (NDMC), Taipei, Taiwan.
authors: Feng-Yi
authors: FY
authors: Chang
authors: Department of Internal Medicine, National Cheng-Kung University Hospital, Tainan, Taiwan.
authors: Wen-Chien
authors: WC
authors: Ko
authors: Emergency Department, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors: Ray-Jade
authors: RJ
authors: Chen
authors: School of Medical Technology, National Cheng-Kung University College of Medicine, Tainan, Taiwan.
authors: Jiunn-Jong
authors: JJ
authors: Wu
authors: Department of Internal Medicine, Kaohsiung Medical University Hospital, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Yen-Hsu
authors: YH
authors: Chen
authors: Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaoshiung, Taiwan.
authors: Yao-Shen
authors: YS
authors: Chen
authors: Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung Medical College, Kaohsiung, Taiwan.
authors: Jien-Wei
authors: JW
authors: Liu
authors: Department of Laboratory Medicine and Internal Medicine, Chung Shan Medical and Dental University, Taichung, Taiwan.
authors: Min-Chi
authors: MC
authors: Lu
authors: Emergency Department, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors: Carlos
authors: C
authors: Lam
authors: Division of Infectious Diseases, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Cheng-Yi
authors: CY
authors: Liu
authors: Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.
authors: Po-Ren
authors: PR
authors: Hsueh
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D002511:Cephalosporins / Q000494:pharmacology*; D003091:Colistin / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; C443755:ceftobiprole; D003091:Colistin
keywords: carbapenem; ceftobiprole; colistin; intensive care unit; nonsusceptibility