Current status of antimicrobial resistance in Taiwan

Abstract

While some trends in antimicrobial resistance rates are universal, others appear to be unique for specific regions. In Taiwan, the strikingly high prevalence of resistance to macrolides and streptogramin in clinical isolates of gram-positive bacteria correlates with the widespread use of these agents in the medical and farming communities, respectively. The relatively low rate of enterococci that are resistant to glycopeptide does not parallel the high use of glycopeptides and extended-spectrum beta-lactams in hospitals. The evolving problem of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates is substantial, and some unique enzymes have been found. Recently, some gram-negative bacteria (e.g., Pseudomonas aeruginosa and Acinetobacter baumannii) that are resistant to all available antimicrobial agents including carbapenems have emerged.

Figure

A, Macrolides consumption (gram x 1000,000) in Taiwan and the trends of erythromycin-resistant group A Streptococcus (EM-R GAS), group B Streptococcus (EM-R GBS), and S. pneumoniae in National Taiwan University Hospital from 1991 to 2000. Macrolides include intravenous and oral forms of erythromycin and oral forms of clarithromycin, roxithromycin, and azithromycin. B,. Distribution of erythromycin-resistant M-phenotype among isolates of streptococci. Other streptococci include Groups C, F, and G, and viridans group streptococci. Number in each bar indicates the percentage of erythromycin-resistant isolates. Number above each bar indicates the percentage of M-phenotype among erythromycin-resistant isolates.