Antimicrobial susceptibilities of Proteus mirabilis: a longitudinal nationwide study from the Taiwan surveillance of antimicrobial resistance (TSAR) program

Wang, Jann-Tay; Chen, Pei-Chen; Chang, Shan-Chwen; Shiau, Yih-Ru; Wang, Huiying; Lai, Jui-Fen; Huang, I-Wen; Tan, Mei-Chen; Lauderdale, Tsai‐Ling

doi:10.1186/1471-2334-14-486

Cited by 71 publications

(59 citation statements)

References 30 publications

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“…In contrast, no dominant β-lactamase genes are carried by ICE Pmi Chn117, suggesting that the class A β-lactamase gene might have been obtained via horizontal gene transfer or recombination. In summary, our study reported multi-drug resistance, including the increasing prevalence of class A β-lactamase-producing P. mirabilis , which is consistent with the trends in Japan16, Taiwan39 and other reports2440. In conclusion, our results present abundant genetic diversity and multidrug resistance of ICEs carried by Proteus strains from both food sources and diarrhoeal patients.…”

Section: Discussionsupporting

confidence: 91%

SXT/R391 integrative and conjugative elements in Proteus species reveal abundant genetic diversity and multidrug resistance

et al. 2016

Sci Rep

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SXT/R391 integrative and conjugative elements (ICEs) are self-transmissible mobile genetic elements that are found in most members of Enterobacteriaceae. Here, we determined fifteen SXT/R391 ICEs carried by Proteus isolates from food (4.2%) and diarrhoea patients (17.3%). BLASTn searches against GenBank showed that the fifteen SXT/R391 ICEs were closely related to that from different Enterobacteriaceae species, including Proteus mirabilis. Using core gene phylogenetic analysis, the fifteen SXT/R391 ICEs were grouped into six distinct clusters, including a dominant cluster and three clusters that have not been previously reported in Proteus isolates. The SXT/R391 ICEs shared a common structure with a set of conserved genes, five hotspots and two variable regions, which contained more foreign genes, including drug-resistance genes. Notably, a class A β-lactamase gene was identified in nine SXT/R391 ICEs. Collectively, the ICE-carrying isolates carried resistance genes for 20 tested drugs. Six isolates were resistant to chloramphenicol, kanamycin, streptomycin, trimethoprim-sulfamethoxazole, sulfisoxazole and tetracycline, which are drug resistances commonly encoded by ICEs. Our results demonstrate abundant genetic diversity and multidrug resistance of the SXT/R391 ICEs carried by Proteus isolates, which may have significance for public health. It is therefore necessary to continuously monitor the antimicrobial resistance and related mobile elements among Proteus isolates.

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Section: Discussionsupporting

confidence: 91%

SXT/R391 integrative and conjugative elements in Proteus species reveal abundant genetic diversity and multidrug resistance

et al. 2016

Sci Rep

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“…strains, isolated from patients with bacteremia, were resistant to co-trimoxazole. High resistance to cotrimoxazole was reported also in another paper (Wang et al 2014). Among 158 examined strains isolated from blood samples during longitudinal nationwide study from the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program, the resistance of P. mirabilis to co-trimoxazole was found in 65.2% strains.…”

Section: Discussionsupporting

confidence: 54%

“…Ahn et al (2017) confirmed that most P. mirabilis isolates from BSIs were susceptible to piperacillin with tazobactam (98.3%) and amikacin (93.5%). In the study by Wang et al (2014), 58.9-87.3% of P. mirabilis strains isolated from blood samples were susceptible to gentamicin and amikacin, respectively. This is in agreement with the present results.…”

Section: Discussionmentioning

confidence: 97%

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Primary and Secondary Bacteremia Caused by Proteus spp.: Epidemiology, Strains Susceptibility and Biofilm Formation

Kwiecińska-Piróg

Skowron

Gospodarek‐Komkowska

2018

Polish Journal of Microbiology

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Proteus spp. is an etiological factor of urinary tract and bloodstream infections. The aim of this study was the retrospective analysis of susceptibility of Proteus spp. strains isolated from bloodstream infections (BSIs) as well as similarity evaluation of the strains isolated from different clinical samples. Proteus spp. strains were isolated in 2009–2017 from hospital patients. Identification was based on the colony’s morphology and biochemical or MALDI-TOF MS analyzes. The antibiotic susceptibility test was done using the diffusion method. Biofilm formation was evaluated with microplate method using TTC. Bacteremia caused by Proteus spp. was found in 97 patients, mainly secondary to urinary tract infection. Most of the strains were susceptible to piperacillin with tazobactam (95.9%) and amikacin (86.7%). Elderly patients have a higher risk of mortality after BSIs caused by Proteus spp. A detailed analysis was made for randomly chosen 26 strains isolated from 11 patients with Proteus mirabilis bacteremia. Using PFGE, we found that 10 (90.9%) isolates, collected from different clinical specimens of the same patient, were genetically identical.

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“…During the collection year, isolates were collected from July to September from 25–28 regional hospitals and medical centers located in different geographical regions of Taiwan. Detailed collection protocol has been published previously45. All isolates were stored at −70 °C.…”

Section: Methodsmentioning

confidence: 99%

The Antimicrobial Susceptibility of Klebsiella pneumoniae from Community Settings in Taiwan, a Trend Analysis

Lin

Wang

Chang

et al. 2016

Sci Rep

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Drug-resistant Klebsiella pneumoniae, especially extended-spectrum β-lactamase (ESBL)- and/or AmpC β-lactamase-producing strains, is an emerging problem worldwide. However, few data focusing on drug susceptibility of K. pneumoniae from community is available. In this study, we analyzed 1016 K. pneumoniae isolates from outpatients or those visiting emergency rooms collected during 2002–2012 from Taiwan Surveillance of Antimicrobial Resistance program. Significantly decreased susceptibilities to 3rd generation cephalosporins and ciprofloxacin were found during the study period. By 2012, susceptibility to cefotaxime and ciprofloxacin was 83.6% and 81.6%, respectively. The prevalence of ESBL-producers increased from 4.8% in 2002 to 11.9% in 2012 (P = 0.012), while that of AmpC β-lactamase-producers increased from 0% to 9.5% in the same period (P < 0.001). Phylogenic analysis of the ESBL and AmpC-β-lactamase-producers by pulsed-field gel electrophoresis and multi-locus sequence typing revealed wide genetic diversity even among the most common sequence type 11 isolates (33.0%). By multivariate analysis, later study year, elderly, and urine isolates were associated with carriage of ESBL genes, while only urine isolates were associated with carriage of AmpC β-lactamase genes. Further studies are needed to determine which antibiotics are reasonable empirical therapy options for patients presenting with severe sepsis that might be caused by K. pneumoniae.

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Antimicrobial susceptibilities of Proteus mirabilis: a longitudinal nationwide study from the Taiwan surveillance of antimicrobial resistance (TSAR) program

Cited by 71 publications

References 30 publications

SXT/R391 integrative and conjugative elements in Proteus species reveal abundant genetic diversity and multidrug resistance

SXT/R391 integrative and conjugative elements in Proteus species reveal abundant genetic diversity and multidrug resistance

Primary and Secondary Bacteremia Caused by Proteus spp.: Epidemiology, Strains Susceptibility and Biofilm Formation

The Antimicrobial Susceptibility of Klebsiella pneumoniae from Community Settings in Taiwan, a Trend Analysis

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