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Antimicrobial resistance among imipenem-non-susceptible Escherichia coli and Klebsiella pneumoniae isolates, with an emphasis on novel β-lactam/β-lactamase inhibitor combinations and tetracycline derivatives: The Taiwan surveillance of antimicrobial resistance program, 2020–2022

Year: 2025
Type: article
Abstract: To determine susceptibility of imipenem-non-susceptible Escherichia coli (INS-EC) and Klebsiella pneumoniae (INS-KP) isolates collected during 2020–2022 through a national surveillance program in Taiwan to novel antibiotics, and to compare the results with those obtained during 2012–2018. Minimum inhibitory concentrations were determined by broth microdilution methods. Genes encoding carbapenemases including bla KPC , metallo-β-lactamase (MBL) genes, and bla OXA-48 were detected via multiplex PCR. Data retrieved from our 2012–2018 study were used for comparison. Of 3260 E. coli and 1457 K. pneumoniae isolates collected during 2020–2022, 0.9 % and 9.5 %, were INS-EC and INS-KP, respectively. Cefepime-zidebactam, ceftazidime-avibactam, imipenem-relebactam, and meropenem-vaborbactam were active against 100 %, 75.9 %, 65.5 %, and 79.3 % of 29 INS-EC isolates respectively; and against 100 %, 90.6 %, 64.5 %, and 67.4 % of 138 INS- KP isolates, respectively. Susceptibility was contingent upon carbapenemase types. Susceptibility rates of cefepime-zidebactam and ceftazidime-avibactam remained constant from 2012 to 2018 through 2020–2022 but those of imipenem-relebactam and meropenem-vaborbactam decreased significantly, which may be partially attributable to the increasing prevalence of bla OXA-48 . Eighteen MBL-gene-positive isolates and two bla KPC -positive isolates were resistant to ceftazidime-avibactam, whereas all were susceptible to cefepime-zidebactam. Tigecycline had a higher susceptibility rate than eravacycline and omadacycline for K. pneumoniae isolates. Lascufloxacin and delafloxacin were effective against fewer than 10 % of INS isolates. Susceptibilities to novel tetracyclines and fluoroquinolones remained similar from 2012 to 2018 through 2020–2022. This study highlights significant resistance patterns of INS-EC and INS-KP isolates in Taiwan. The declining susceptibility rates and the rising prevalence of genetic resistance determinants highlight the importance of ongoing surveillance and antimicrobial stewardship.
DOI: 10.1016/j.jmii.2025.01.006
Authors: Yu-Lin Lee, Chun-Eng Liu, Wei-Yao Wang, Mei-Chen Tan, Pei-Jing Chen, Yih-Ru Shiau, Hui-Ying Wang, Jui-Fen Lai, I-Wen Huang, Ya-Sung Yang, Shu-Chen Kuo
Institutions: National Chung Hsing University, Chung Shan Medical University Hospital, Chung Shan Medical University, Changhua Christian Hospital, National Health Research Institutes, Tri-Service General Hospital, National Defense Medical Center
Language: English
Open Access status: gold
Estimated APC paid: $2,000
Funders: National Science and Technology Council, National Defense Medical Center, National Health Research Institutes, Tri-Service General Hospital, Chung Shan Medical University Hospital, Taiwan Centers for Disease Control
Awards: G1115484787, G1547723851, Investigation of in Vitro and in Vivo Efficacies of Novel Β-Lactamase Inhibitors in Combination with Cefepime against Elizabethkingia Species and the Potential Resistance Mechanism, In Vitro and in Vivo Efficacies of Cefiderocol against Elizabethkingia Species and Investigation of the Mechanisms for Resistance., G3412989694, G3951739754, G3997051903, G4214501761, G4500905393, G4519251552, Leveraging Immunopeptidomic and Immunoproteomic to Develop Multi-Epitope Vaccine against Elizabethkingia Anophelis Infection, G7982817548
OpenAlex ID: W4407196352
FWCI: 2.34
Cites: 33
Cited by: 10
Related to: 10