投稿分類 微生物

主委發表種類: 壁報

投稿標題(中): 利用VITEK 2.0系統對後線抗生素具抗藥性菌株之流行病學及基因分析

投稿標題(英): VITEK 2.0 system-based epidemiological and genetic analyses of last-line antibiotics-resistant bacteria

投稿摘要: Introduction:
Carbapenems are last-line antimicrobial agents for Gram-negative bacilli, so as vancomycin and teicoplanin for Gram-positive cocci. Herein, we analyzed the epidemiology of vancomycin/teicoplanin-resistant aerobic Gram-positive cocci and ertapenem/meropenem-resistant aerobic Gram-negative bacilli and assessed related drug resistance genes.
Material and methods:
Bacterial identification was conducted using matrix-assisted laser desorption ionization-time of flight mass spectrometry analysis. The antimicrobial susceptibility testing data from May 2015 to October 2022 by VITEK 2.0 system were collected. Results were interpreted according to the guidelines from the Clinical & Laboratory Standards Institute supplement M100 32nd edition and M45 3rd Edition
Results:
A total of 177,177 antimicrobial susceptibility testing data were included. Among 74,065 ertapenem-tested data, the minimum inhibitory concentration (MIC) ≧2 μg/mL accounted for 3.25% (2,410). Moreover, among 102,419 meropenem-tested data, MIC of ≧4 μg/mL in Enterobacteriaceae (1036) and ≧8 μg/mL in Pseudomonas and Acinetobacter species (7393) accounted for 1.01% and 7.21%, respectively. Klebsiella pneumonia, Escherichia coli, and Enterobacter cloacae complex are major meropenem-resistant Enterobacteriaceae, while Pseudomonas aeruginosa and Acinetobacter baumannii are major meropenem-resistant non-Enterobacteriaceae. KPC carbapenemase was the major cause of carbapenem resistance in these data, with SME-carbapenemase, CTX-M extended spectrum β-lactamase, and AmpC β-lactamase detected in partial bacterial strains. Regarding Gram-positive cocci, MIC of vancomycin ≧16 μg/mL in Staphylococcus aureus, ≧32 μg/mL in other Staphylococci, ≧32 μg/mL in Enterococci, and ＞1 μg/mL in Streptotocci accounted for 0.36% (54 of 14,959), 0.23% (38 of 16,338), 20.44% (3,666 of 17,934), and 0.80% (91 of 11,315), respectively. Enterococcus faecium was the predominant species of vancomycin-resistant Enterococci (95.47%), followed by Enterococcus faecalis (1.58%), and Enterococcus gallinarum (0.73%). Van A-type resistance was detected in 1516 cases, while Van B-type and Van C-type resistance were detected in 46 and 12 cases, respectively.
Discussion:
This study, with the inclusion of large-scale antimicrobial susceptibility testing data, may help us better monitor the trend and distributions of last-line drug-resistant microbes, thus making the Division of Infectious Disease and the Antibiotic Stewardship at our center established optimal operating procedures for the management of severe drug-resistant bacteria.

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