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Nationwide surveillance of antimicrobial resistance among Enterobacteriaceae in intensive care units in Taiwan

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Abstract

To determine the antimicrobial resistance profiles among clinical isolates of Enterobacteriaceae in Taiwanese intensive care units (ICUs), a national surveillance of antibiotic resistance among important Enterobacteriaceae was conducted from September 2005 through November 2005 at the ICUs of ten major teaching hospitals in Taiwan. A total of 574 Enterobacteriaceae isolates recovered from various clinical samples of our ICU patients were submitted for in vitro test. Minimum inhibitory concentrations (MICs) of these isolates to 18 antimicrobial agents were determined by the broth microdilution method. The prevalences of Enterobacteriaceae isolates with phenotypic extended-spectrum β-lactamase (ESBL) production were 26% in Klebsiella pneumoniae, 16% in Serratia marcescens, 14% in Escherichia coli, and 13% in Proteus mirabilis, in which a significantly rising prevalence of ESBL production among K. pneumoniae was noted (p = 0.002) when compared with a previous Taiwanese survey in 2000. Heterogeneous resistance to various fluoroquinolones was found among our Enterobacteriaceae isolates, except for Entetrobacter cloacae. Emergence of ertapenem-resistant isolates of E. coli, K. pneumoniae, E. cloacae, and S. marcescens was noted. Gradually increasing rates of drug-resistant Enterobacteriaceae were noted in Taiwanese ICUs. Periodic surveillance of the evolutionary trend of antimicrobial resistance among ICU isolates is crucial for starting appropriately empirical antimicrobial therapy in the future.

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Authors and Affiliations

  1. Departments of Intensive Care Units and Internal Medicine, Min-Sheng General Hospital, Taoyuan County, Taiwan

    S.-S. Jean

  2. Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University Medical College, 7 Chung-Shan South Road, 100, Taipei, Taiwan

    P.-R. Hsueh

  3. Department of Internal Medicine, Taipei Municipal WanFang Hospital, Taipei, Taiwan

    W.-S. Lee

  4. Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei County, Taiwan

    H.-T. Chang

  5. Department of Internal Medicine, Cheng Hsin Rehabilitation Medical Center, Taipei, Taiwan

    M.-Y. Chou

  6. Department of Internal Medicine, Cardinal Tien Hospital, Taipei County, Taiwan

    I.-S. Chen

  7. Department of Internal Medicine, China Medical College Hospital, Taichung, Taiwan

    J.-H. Wang

  8. Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan

    C.-F. Lin

  9. Department of Clinical Pathology, Taichung Veterans General Hospital, Taichung, Taiwan

    J.-M. Shyr

  10. Departments of Internal Medicine, National Cheng-Kung University Hospital, Tainan, Taiwan

    W.-C. Ko

  11. School of Medical Technology, National Cheng-Kung University College of Medicine, Tainan, Taiwan

    J.-J. Wu

  12. Department of Clinical Pathology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Y.-C. Liu

  13. Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    W.-K. Huang

  14. School of Medical Technology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

    L.-J. Teng

  15. Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    C.-Y. Liu

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  1. S.-S. Jean
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  2. P.-R. Hsueh
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  3. W.-S. Lee
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  7. J.-H. Wang
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  8. C.-F. Lin
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  10. W.-C. Ko
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  11. J.-J. Wu
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  13. W.-K. Huang
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  14. L.-J. Teng
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  15. C.-Y. Liu
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Corresponding author

Correspondence to P.-R. Hsueh.

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Jean, SS., Hsueh, PR., Lee, WS. et al. Nationwide surveillance of antimicrobial resistance among Enterobacteriaceae in intensive care units in Taiwan. Eur J Clin Microbiol Infect Dis 28, 215–220 (2009). https://doi.org/10.1007/s10096-008-0610-7

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  • DOI: https://doi.org/10.1007/s10096-008-0610-7

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