To better understand the resistance status in Taiwan, our recent study delineated the trend of antimicrobial resistance in GBS isolates in the Taiwan Surveillance of Antimicrobial Resistance (TSAR) collection and clinical and molecular characteristics of levofloxacin-resistant isolates. A total of 1,559 isolates were tested and all remained susceptible to penicillin, cephalosporins, meropenem, and vancomycin. However, rates of resistance to erythromycin (42.5%), clindamycin (29.9%), and tetracycline (82.3%) remained high, and rate of levofloxacin resistance increased over time, from 2.2% in 2002-2006 to 6.2 % in 2008-2012. Molecular-level surveillance revealed multiclonal emergence and local spread of levofloxacin-resistant GBS isolates in Taiwan. Emergence of resistance under fluoroquinolone selective pressure and clonal expansion likely both contributed to the increasing resistance. This study underlines the importance of monitoring fluoroquinolone use and reducing transmission opportunities. Continuous molecular-level surveillance should also be carried to detect emerging resistant clones.
(References: Principles and Practice of Infectious Diseases, 8th edition; J Antimicrob Chemother. 2017; 72: 3263-3271)