行政院國家科學委員會專題研究計畫 期中進度報告
台灣地區肺炎鏈球菌抗藥性趨勢調查-著重在
Fluoroquinolone 抗藥性菌株之浮現(2/3)
計畫類別： 個別型計畫 計畫編號： NSC92-2314-B-002-104- 執行期間： 92 年 08 月 01 日至 93 年 07 月 31 日 執行單位： 國立臺灣大學醫學院檢驗醫學科 計畫主持人： 薛博仁 報告類型： 精簡報告 報告附件： 出席國際會議研究心得報告及發表論文 處理方式： 本計畫可公開查詢中 華 民 國 93 年 6 月 4 日
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Antimicrobial Resistance Patterns of and Activities of
Tigecycline against Clinical Isolates of Streptococcus
pneumoniae from the SMART Program in Taiwan, 2003
Po-Ren Hsueh,
1*Wen-Kuei Huang,
2Lee-Jene Teng,
3Jainn-Ming Shyr,
4and Yung-Ching Liu
4,51
Departments of Laboratory Medicine and Internal Medicine, and 3School of Mediial Technology, National Taiwan University hospital, National Taiwan University College of Medicine, Taipei; Department of 2Clinical Pathology and 5Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung; and 4Department of Clinical Pathology, Taichung
Veterans General Hospital, Taichung, Taiwan
From August 2003 to December 2003, three medical centers located in northern, central, and southern regions of Taiwan participated in the MYSTIC program. The three hospitals included National Taiwan University Hospital (NTUH) in Taipei (2000 beds), Taichung Veterans General Hospital in Taichung (VGH-Taichung) (1400 beds), and Kaohsiung Veterans General Hospital in Kaohsiung (VGH-Kaohsiung) (1600 beds).
A total of 194 isolates of S. pneumoniae were collected from patients with infections in the three hospitals. Prior to susceptibility testing, these isolates were stored at –70oC. Antimicrobial agents were provided by their manufacturersfor use in this study (Table 1). Minimum inhibitory concentrations (MICs) were determined for all isolatesusing the agar dilution method according to the guidelines established by the National Committee for Clinical Laboratory Standards (NCCLS). Regular quality assurance was performed among isolates processing with the American Type Culture Collection (ATCC) strains:
Staphylococcus aureus ATCC 29213, Enterococcusfaecalis ATCC 29212, S. pneumoniae
ATCC 49619,Interpretive criteria for susceptibility and resistance for each antimicrobial agent followed those recommended by the NCCLS.
MICs of antimicrobial agents tested for all the control strains were within the MIC ranges provided by the NCCLS. In vitro susceptibilities of this collection of
S. pneumoniae species to 17 selected antimicrobial agents are shown in Table 1.
Seventy-two percent of 194 S. pneumoniae isolates were not susceptible to penicillin (intermediate [MICs, 0.12-1 µg/ml], 69%, and resistant [MICs, ≥2 µg/ml], 3%) and 30% were not susceptible to cefotaxime (intermediate [MICs, 1 µg/ml], 27%, and resistant
[MICs, ≥2 µg/ml], 3%) based on meningitis criteria provided by the NCCLS. Two (1%) isolates of S. pneumoniae exhibited cefotaxime MICs of ≥4 µg/ml.
Tigecycline had excellent in vitro activities against S. pneumoniae isolates (MICs, ≤0.06 µg/ml).
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TABLE 1. Antimicrobial susceptibilities of 194 isolates of S. pneumoniae recovered from patients treated at three major teaching hospitals in Taiwan, MYSTIC-Taiwan antimicrobial surveillance programme, 2003.
Antimicrobial MIC (µg/ml) No. (%) of isolates agent Range MIC50 MIC90 S I R
Penicillin 0.03-2 0.5 1 56 (29) 133 (69) 5 (3) 189 (97) 5 (3) 0 (0) Cefotaxime 0.03-4 0.5 1 136 (70) 53 (27) 5 (3) 189 (97) 3 (2) 2 (1) Cefepime 0.03-4 1 1 80 (41) 104 (54) 10 (5) 184 (95) 8 (4) 2 (1) Cefpirome 0.03-2 0.5 0.5 - - - Imipenem 0.03-1 0.12 0.25 169 (87) 24 (12) 1 (1) Meropenem 0.03-0.5 0.25 0.5 156 (80) 38 (20) 0 (0) Ertapenem 0.03-4 0.5 1 190 (98) 3 (2) 1 (1) Ciprofloxacin 0.12->32 1 2 - - - Levofloxacin 0.12->32 1 1 189 (97) 0 (0) 5 (3) Moxifloxacin 0.03-16 0.12 0.12 192 (99) 1 (1) 1 (1) Gatifloxacin 0.03-32 0.25 0.25 189 (97) 2 (1) 3 (2) Vancomycin 0.12-0.5 0.25 0.25 194 (100) - - Q/D 0.5-8 2 4 83 (42) 60 (31) 51 (26) Linezolid 0.25-2 1 1 194 (100) - - Telithromycin 0.03-8 0.25 2 173 (89) 13 (7) 8 (4) Telithromycin* 0.03-2 0.03 0.25 155 (97) 4 (3) 0 (0) Tigecycline 0.03-0.06 0.03 0.06 - - -
FIG. 1. MIC distribution of penicillin, telithromycin, and quinupristin-dalfopristin to
194 S. pneumoniae isolates recovered from patients treated at three major teaching hospitals in Taiwan, MYSTIC-Taiwan antimicrobial surveillance programme, 2003.
