Open AccessThe Antimicrobial Susceptibility of Klebsiella pneumoniae from Community Settings in Taiwan, a Trend Analysis
Author(s) -
Wu-Pu Lin,
Jann-Tay Wang,
ShanChwen Chang,
Feng–Yee Chang,
Chang-Phoné Fung,
Yin-Ching Chuang,
Yao-Shen Chen,
Yih-Ru Shiau,
Mei-Chen Tan,
Huiying Wang,
Jui-Fen Lai,
I-Wen Huang,
TsaiLing Lauderdale
Publication year - 2016
Publication title -
scientific reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.24
H-Index - 213
ISSN - 2045-2322
DOI - 10.1038/srep36280
Subject(s) - klebsiella pneumoniae , cefotaxime , ciprofloxacin , cephalosporin , microbiology and biotechnology , carriage , antibiotics , biology , beta lactamase , medicine , escherichia coli , gene , genetics , pathology
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 3 rd 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 .