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Current status of antimicrobial resistance in Taiwan.

Hsueh PR, Liu CY, Luh KT - Emerging Infect. Dis. (2002)

Bottom Line: While some trends in antimicrobial resistance rates are universal, others appear to be unique for specific regions.The relatively low rate of enterococci that are resistant to glycopeptide does not parallel the high use of glycopeptides and extended-spectrum beta-lactams in hospitals.The evolving problem of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates is substantial, and some unique enzymes have been found.

View Article: PubMed Central - PubMed

Affiliation: National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

ABSTRACT
While some trends in antimicrobial resistance rates are universal, others appear to be unique for specific regions. In Taiwan, the strikingly high prevalence of resistance to macrolides and streptogramin in clinical isolates of gram-positive bacteria correlates with the widespread use of these agents in the medical and farming communities, respectively. The relatively low rate of enterococci that are resistant to glycopeptide does not parallel the high use of glycopeptides and extended-spectrum beta-lactams in hospitals. The evolving problem of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates is substantial, and some unique enzymes have been found. Recently, some gram-negative bacteria (e.g., Pseudomonas aeruginosa and Acinetobacter baumannii) that are resistant to all available antimicrobial agents including carbapenems have emerged.

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A, Macrolides consumption (gram x 1000,000) in Taiwan and the trends of erythromycin-resistant group A Streptococcus (EM-R GAS), group B Streptococcus (EM-R GBS), and S. pneumoniae in National Taiwan University Hospital from 1991 to 2000. Macrolides include intravenous and oral forms of erythromycin and oral forms of clarithromycin, roxithromycin, and azithromycin. B,. Distribution of erythromycin-resistant M-phenotype among isolates of streptococci. Other streptococci include Groups C, F, and G, and viridans group streptococci. Number in each bar indicates the percentage of erythromycin-resistant isolates. Number above each bar indicates the percentage of M-phenotype among erythromycin-resistant isolates.
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Figure 1: A, Macrolides consumption (gram x 1000,000) in Taiwan and the trends of erythromycin-resistant group A Streptococcus (EM-R GAS), group B Streptococcus (EM-R GBS), and S. pneumoniae in National Taiwan University Hospital from 1991 to 2000. Macrolides include intravenous and oral forms of erythromycin and oral forms of clarithromycin, roxithromycin, and azithromycin. B,. Distribution of erythromycin-resistant M-phenotype among isolates of streptococci. Other streptococci include Groups C, F, and G, and viridans group streptococci. Number in each bar indicates the percentage of erythromycin-resistant isolates. Number above each bar indicates the percentage of M-phenotype among erythromycin-resistant isolates.

Mentions: Under the increasing and highly selective pressure of macrolide usage in Taiwan, the prevalence of macrolide resistance and distribution of M-phenotype (mef gene-positive) among macrolide-resistant isolates vary among different streptococcal species (Figure) (26–31). More than 90% of the S. pneumoniae isolates were resistant to macrolides, and approximately two thirds exhibited high-level resistance (MLSB phenotype-erm gene-positive) (29). However, macrolide resistance accounted for 50% to 60% of all clinical isolates of S. pyogenes, and a stepwise increase of proportion of M phenotype was clearly demonstrated (29).


Current status of antimicrobial resistance in Taiwan.

Hsueh PR, Liu CY, Luh KT - Emerging Infect. Dis. (2002)

A, Macrolides consumption (gram x 1000,000) in Taiwan and the trends of erythromycin-resistant group A Streptococcus (EM-R GAS), group B Streptococcus (EM-R GBS), and S. pneumoniae in National Taiwan University Hospital from 1991 to 2000. Macrolides include intravenous and oral forms of erythromycin and oral forms of clarithromycin, roxithromycin, and azithromycin. B,. Distribution of erythromycin-resistant M-phenotype among isolates of streptococci. Other streptococci include Groups C, F, and G, and viridans group streptococci. Number in each bar indicates the percentage of erythromycin-resistant isolates. Number above each bar indicates the percentage of M-phenotype among erythromycin-resistant isolates.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369580&req=5

Figure 1: A, Macrolides consumption (gram x 1000,000) in Taiwan and the trends of erythromycin-resistant group A Streptococcus (EM-R GAS), group B Streptococcus (EM-R GBS), and S. pneumoniae in National Taiwan University Hospital from 1991 to 2000. Macrolides include intravenous and oral forms of erythromycin and oral forms of clarithromycin, roxithromycin, and azithromycin. B,. Distribution of erythromycin-resistant M-phenotype among isolates of streptococci. Other streptococci include Groups C, F, and G, and viridans group streptococci. Number in each bar indicates the percentage of erythromycin-resistant isolates. Number above each bar indicates the percentage of M-phenotype among erythromycin-resistant isolates.
Mentions: Under the increasing and highly selective pressure of macrolide usage in Taiwan, the prevalence of macrolide resistance and distribution of M-phenotype (mef gene-positive) among macrolide-resistant isolates vary among different streptococcal species (Figure) (26–31). More than 90% of the S. pneumoniae isolates were resistant to macrolides, and approximately two thirds exhibited high-level resistance (MLSB phenotype-erm gene-positive) (29). However, macrolide resistance accounted for 50% to 60% of all clinical isolates of S. pyogenes, and a stepwise increase of proportion of M phenotype was clearly demonstrated (29).

Bottom Line: While some trends in antimicrobial resistance rates are universal, others appear to be unique for specific regions.The relatively low rate of enterococci that are resistant to glycopeptide does not parallel the high use of glycopeptides and extended-spectrum beta-lactams in hospitals.The evolving problem of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates is substantial, and some unique enzymes have been found.

View Article: PubMed Central - PubMed

Affiliation: National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

ABSTRACT
While some trends in antimicrobial resistance rates are universal, others appear to be unique for specific regions. In Taiwan, the strikingly high prevalence of resistance to macrolides and streptogramin in clinical isolates of gram-positive bacteria correlates with the widespread use of these agents in the medical and farming communities, respectively. The relatively low rate of enterococci that are resistant to glycopeptide does not parallel the high use of glycopeptides and extended-spectrum beta-lactams in hospitals. The evolving problem of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates is substantial, and some unique enzymes have been found. Recently, some gram-negative bacteria (e.g., Pseudomonas aeruginosa and Acinetobacter baumannii) that are resistant to all available antimicrobial agents including carbapenems have emerged.

Show MeSH
Related in: MedlinePlus