Current Status of Antimicrobial Resistance in Taiwan

Hsueh, Po-Ren; Liu, Cheng-Yi; Luh, Kwen‐Tay

doi:10.3201/eid0802.010244

Cited by 134 publications

(97 citation statements)

References 37 publications

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“…The rate of resistance to clindamycin (92.9%) among the C-MRSA iso- lates from subjects without risk factors in this study was also higher than that in a study from the United States (10), in which most C-MRSA isolates from subjects without risk factors were susceptible to clindamycin. The high rate of resistance to clindamycin among our community MRSA isolates (90.6%) was similar to the rate of resistance among clinical MRSA isolates in Taiwan (94.2%) (13,41), indicating that clindamycin resistance is quite common among community and health care facility-related MRSA isolates in Taiwan. This study found that recent receipt of medical services was the major factor associated with MRSA colonization as well as the high level of multiple-drug resistance in MRSA nasal isolates.…”

Section: Discussionmentioning

confidence: 55%

Risk Factors and Molecular Analysis of Community Methicillin-Resistant Staphylococcus aureus Carriage

Chin²,

Peng

et al. 2005

J Clin Microbiol

113

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A total of 1,838 subjects from the community and 393 subjects from health care-related facilities in Taiwan were evaluated for the prevalence of nasal Staphylococcus aureus colonization and to identify risk factors associated with S. aureus and methicillin-resistant S. aureus (MRSA) colonization. Among the community subjects, 3.5% had nasal MRSA colonization. Subjects from health care-related facilities had a lower S. aureus colonization rate (19.1%) than community subjects (25.2%) but had a significantly higher rate of colonization with MRSA (7.63%). Age (P < 0.001) was a significant risk factor for S. aureus colonization, with subjects under age 20 years or between 71 and 80 years showing higher rates of colonization. Recent gastrointestinal disease (P ‫؍‬ 0.011) and hospital admission (P ‫؍‬ 0.026) were risk factors for nasal MRSA colonization. Comparison of hospital MRSA isolates with the colonization strains by staphylococcal cassette chromosome mec (SCCmec) gene typing and pulsed-field gel electrophoresis (PFGE) typing revealed that most MRSA strains carried in the community were SCCmec type IV and that most clinical hospital isolates were type III, while health care facility-related carriage isolates were mainly SCCmec type III and type IV. Two new variant SCCmec types were identified. Six clusters of PFGE patterns were distinguished: two mainly comprised health care facility-related MRSA strains, three mainly comprised community MRSA strains, and one comprised mixed community and health care facility-related MRSA strains. In conclusion, a high prevalence of MRSA colonization was observed among people with no relationship to the hospital setting. The high level of multiple-drug resistance among community MRSA strains in association with the previously reported excessive use of antibiotics in Taiwan highlights the importance of the problem of antibiotic selective pressure. Our results indicate that both the clonal spread of MRSA and the transmission of hospital isolates contribute to the high MRSA burden in the community.

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Section: Discussionmentioning

confidence: 55%

Risk Factors and Molecular Analysis of Community Methicillin-Resistant Staphylococcus aureus Carriage

Chin²,

Peng

et al. 2005

J Clin Microbiol

113

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“…5 Before the 2003 epidemic of severe acute respiratory syndrome, the prevalence of HA-MRSA in Taiwan increased from 26.7% in 1990 to 60% in 1998-2000, 6 then increased to 53-83% in 2003. 7 Interestingly, after the 2003 severe acute respiratory syndrome epidemic, there was a decline in the prevalence of HA-MRSA in Taiwan. Lee et al 2 reported that the prevalence of MRSA decreased from 63.…”

Section: Introductionmentioning

confidence: 99%

Time-series analysis of the relationship of antimicrobial use and hand hygiene promotion with the incidence of healthcare-associated infections

et al. 2012

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We analyzed the effect of antimicrobial use and implementation of a hand hygiene program on the incidence of healthcareassociated infections (HAIs) and healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) infections at the Chung Shan Medical University Hospital (Taichung, Taiwan). Monthly data were retrospectively reviewed from January 2004 to December 2010. Use of antimicrobials and alcohol-based hand cleaner were separately regressed against the incidences of HAIs and HA-MRSA infections. Infection incidence was expressed as persons per 1000 patient days (PDs), monthly use of i.v. antibiotics was expressed as defined daily doses per 1000 PDs and monthly alcohol-based hand cleaner use was expressed as bottle per 1000 PDs. Multivariate analysis indicated that use of hand cleaner was associated with reduced incidence of HAIs (P ¼ 0.0001) and HA-MRSA infections (Po0.0001). Time-series analysis indicated that increased use of hand cleaner was significantly associated with significant decreases in the incidences of HAIs and HA-MRSA infections. Total antibiotic use had no significant effect on HAIs, but was associated with more HA-MRSA infections. In addition, the use of J01CR01 antibiotics (combinations of penicillins, including b-lactamase inhibitors) in particular was correlated with significantly increased incidence of HA-MRSA infections. Our forecasting model demonstrates the efficacy of a hand hygiene program and the need to limit the use of certain restricted antimicrobials in order to reduce the incidence of HAIs and HA-MRSA infections.

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“…Isolates of pandrug-resistant A. baumannii (PDRAB), which are resistant to all antibiotics routinely tested (i.e., ampicillin-sulbactam, ceftazidime, piperacillin-tazobactam, cefepime, aztreonam, ciprofloxacin, trovafloxacin, moxifloxacin, garenoxacin, amikacin, imipenem, and meropenem), were first recovered in May 1998 at the National Taiwan University Hospital (NTUH) (14,17). Since then, clusters of PDRAB infections and nosocomial outbreaks have persisted, although the incidence of nosocomial infections caused by PDRAB has declined in the past 2 years (12,13,15).…”

mentioning

confidence: 99%

Dissemination of a Clone of Unusual Phenotype of Pandrug-Resistant Acinetobacter baumannii at a University Hospital in Taiwan

Kuo¹,

Teng

Yu³

et al. 2004

J Clin Microbiol

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, 15 isolates of pandrug-resistant unidentified Acinetobacter species were recovered from seven patients treated on different wards or intensive care units. Both 16S-23S rRNA intergenic spacer PCR-restriction fragment length polymorphism profiles and sequence analysis of these isolates identified them as Acinetobacter baumannii. This pandrug-resistant A. baumannii strain with an unusual phenotype could persist in humans for long periods and was widely disseminated throughout the hospital.

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Current Status of Antimicrobial Resistance in Taiwan

Cited by 134 publications

References 37 publications

Risk Factors and Molecular Analysis of Community Methicillin-Resistant Staphylococcus aureus Carriage

Risk Factors and Molecular Analysis of Community Methicillin-Resistant Staphylococcus aureus Carriage

Time-series analysis of the relationship of antimicrobial use and hand hygiene promotion with the incidence of healthcare-associated infections

Dissemination of a Clone of Unusual Phenotype of Pandrug-Resistant Acinetobacter baumannii at a University Hospital in Taiwan

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