Lee Yu-Lin, Tan Mei-Chen, Chen Pei-Jing, Shiau Yih-Ru, Wang Hui-Ying, Lai Jui-Fen, Huang I-Wen, Yang Ya-Sung, Kuo Shu-Chen
Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; PhD Program in Medical Biotechnology, Institute of Genomics and Bioinformatics, National Chung-Hsing University, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan.
Int J Antimicrob Agents. 2025 Sep;66(3):107550. doi: 10.1016/j.ijantimicag.2025.107550. Epub 2025 Jun 4.
The global expansion of antimicrobial-resistant Pseudomonas aeruginosa, particularly imipenem-non-susceptible (INS) strains poses a formidable health threat. The COVID-19 pandemic has exacerbated antimicrobial resistance trends. We compared the pre- and post-pandemic antibiotic resistance patterns of INS-P. aeruginosa in Taiwan.
We analysed 503 P. aeruginosa isolates collected through the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program during 2022. Minimum inhibitory concentrations of various antibiotics were determined by using broth microdilution. Carbapenemase-encoding genes were identified via multiplex PCR. Antimicrobial resistance trends were compared with data from 2018.
INS-P. aeruginosa comprised 16.9% (85/503) of isolates and exhibited high-level multi-drug resistance. Novel β-lactam-β-lactamase inhibitor combinations (BL-BLIs) demonstrated the highest activity, with 89.4% of INS isolates remaining susceptible to cefepime-zidebactam. However, the susceptibility rates of INS-P. aeruginosa isolates to other BL-BLIs and comparators declined between 2018 and 2022. Specifically, susceptibility to ceftazidime-avibactam and imipenem-relebactam declined significantly from 81.5% and 85.2% in 2018 to 64.7% and 63.5% in 2022, respectively (both P < 0.05). Additionally, only 70.6% of isolates obtained during 2022 were susceptible to ceftolozane-tazobactam. Carbapenemase genes were detected in 10.6% of isolates, with a notable increase in bla and bla prevalence compared to pre-pandemic data.
The COVID-19 pandemic intensified resistance trends in INS-P. aeruginosa in Taiwan, with increasing prevalence and diversity of carbapenemase-encoding genes. Continuous monitoring and expanded research are essential to combat evolving resistance patterns.
耐抗生素铜绿假单胞菌在全球范围内的传播，尤其是对亚胺培南不敏感（INS）的菌株，对健康构成了巨大威胁。新冠疫情加剧了抗生素耐药性趋势。我们比较了台湾地区疫情前后INS-铜绿假单胞菌的抗生素耐药模式。
我们分析了2022年通过台湾地区抗生素耐药性监测（TSAR）项目收集的503株铜绿假单胞菌分离株。采用肉汤微量稀释法测定各种抗生素的最低抑菌浓度。通过多重PCR鉴定碳青霉烯酶编码基因。将抗生素耐药性趋势与2018年的数据进行比较。
INS-铜绿假单胞菌占分离株的16.9%（85/503），表现出高水平的多重耐药性。新型β-内酰胺-β-内酰胺酶抑制剂组合（BL-BLIs）显示出最高的活性，89.4%的INS分离株对头孢吡肟-西他唑巴坦仍敏感。然而，2018年至2022年期间，INS-铜绿假单胞菌分离株对其他BL-BLIs和对照药物的敏感性有所下降。具体而言，对头孢他啶-阿维巴坦和亚胺培南-瑞来巴坦的敏感性分别从2018年的81.5%和85.2%显著下降至2022年的64.7%和63.5%（P均<0.05）。此外，2022年获得的分离株中只有70.6%对头孢洛扎-他唑巴坦敏感。在10.6%的分离株中检测到碳青霉烯酶基因，与疫情前的数据相比，bla和bla的流行率显著增加。
新冠疫情加剧了台湾地区INS-铜绿假单胞菌的耐药趋势，碳青霉烯酶编码基因的流行率和多样性不断增加。持续监测和扩大研究对于应对不断演变的耐药模式至关重要。
