Shio-Shin Jean1, Wen-Sen Lee2, Kwok-Woon Yu3, Chun-Hsing Liao4, Chin-Wang Hsu1, Feng-Yi Chang5, Wen-Chien Ko6, Ray-Jade Chen1, Jiunn-Jong Wu7, Yen-Hsu Chen8, Yao-Shen Chen9, Jien-Wei Liu10, Min-Chi Lu11, Carlos Lam1, Cheng-Yi Liu12, Po-Ren Hsueh13. 1. Emergency Department, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 2. Division of Infectious Diseases, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 3. Department of Internal Medicine, Pathology and Laboratory Medicine, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan. 4. Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan. 5. Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center (NDMC), Taipei, Taiwan. 6. Department of Internal Medicine, National Cheng-Kung University Hospital, Tainan, Taiwan. 7. School of Medical Technology, National Cheng-Kung University College of Medicine, Tainan, Taiwan. 8. Department of Internal Medicine, Kaohsiung Medical University Hospital, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 9. Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaoshiung, Taiwan. 10. Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung Medical College, Kaohsiung, Taiwan. 11. Department of Laboratory Medicine and Internal Medicine, Chung Shan Medical and Dental University, Taichung, Taiwan. 12. Division of Infectious Diseases, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 13. Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.
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 MIC90 value 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. CONCLUSION: Continuous monitoring of susceptibility profiles of ICU pathogens to important antibiotics is warranted to provide appropriate antimicrobial regimens against infections in the ICU.
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 MIC90 value 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. CONCLUSION: Continuous monitoring of susceptibility profiles of ICU pathogens to important antibiotics is warranted to provide appropriate antimicrobial regimens against infections in the ICU.