Antimicrobial drug resistance in Taiwan.

Antimicrobial resistance is a major health problem worldwide, but marked variations in the resistance profiles of bacterial pathogens are found between countries and in different patient settings, especially in Asia. In Taiwan, the strikingly high prevalence of resistance to macrolides and streptogramins in clinical isolates of Gram-positive bacteria correlates with the widespread use of these agents in the medical and farming communities. The relatively low proportion of enterococci that are resistant to glycopeptides does not equate to the high use of glycopeptides and extended-spectrum beta-lactams in hospitals. The emerging problem of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates is substantial, and some unique enzymes have been found. Recently, Gram-negative bacteria (e.g. Pseudomonas aeruginosa and Acinetobacter baumannii) that are resistant to nearly all available antimicrobial agents, including carbapenems, have emerged.