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Objectives: Small colony variants (SCVs) of Staphylococcus aureus are associated with persistent and drug-resistant infections. We demonstrated for the first time the emergence of SCVs in a patient with vancomycin-intermediate S. aureus (VISA) infection during long-term treatment with daptomycin.Methods: A 73-year-old man with septic arthritis was infected with VISA. The patient was treated with daptomycin; however, the patient remained infected with VISA, with continuous isolation of VISA from his blood during long-term treatment. Five VISA isolates were characterized by: PFGE; genotyping including staphylococcal cassette chromosome mec (SCCmec), spa and MLST; antimicrobial susceptibility testing; and scanning and transmission electron microscopy. WGS and fatty acid analysis were also performed.Results: The five VISA isolates were from a single clone of ST239/spa3(t037) and, of these, the first three were SCCmecIII positive and daptomycin susceptible, whereas the last two were SCCmecIII negative and daptomycin resistant and exhibited the characteristics of SCVs. The first and last isolates showed 13 remarkable genetic differences in SCCmec and the mprF, cls2, clpX and fabF genes. Of these, mutation of fabF (encoding the fatty acid synthase) seemed to be partially responsible for the slow growth and ultrastructural features, including an abnormal intercellular substance, and for the daptomycin resistance of SCVs.Conclusions: For the first time, we identified SCVs of VISA in a patient with septic arthritis during long-term treatment with daptomycin. Daptomycin-resistant SCVs of VISA were evolved in a stepwise manner and the mutation of fabF is likely responsible for the physical and ultrastructural characteristics and daptomycin resistance. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prevalence of metallo-β-lactamases (MBLs) and Tn6001 in carbapenem-non-susceptible Pseudomonas aeruginosa (CNSPA). The CNSPA included extensively drug-resistant P. aeruginosa (XDRPA) and non-XDRPA isolates in Taiwan. [ABSTRACT FROM PUBLISHER]

Among 55 preserved isolates collected in northern Taiwan from 1999 through 2003, ciprofloxacin resistance (minimum inhibitory concentration, ≥1 μg/mL) was found in 1 (25%) of 4 isolates obtained in 1999-2000 and in 27 (93.1%) of 29 isolates obtained in 2003. Pulsed-field gel electrophoresis analysis indicated that several clones predominated among the ciprofloxacin-resistant isolates. [ABSTRACT FROM AUTHOR]

From January 1993 to December 2002, 28 patients with nutritionally variant streptococci (NVS) infections were treated at a university hospital in Taiwan. Twelve (43%) of these patients had various underlying malignancies, and 7 (25%) had underlying valvular heart diseases. Nine patients (32%) had infective endocarditis, and 9 (32%) had primary bacteremia. The deaths of 7 patients (25%) were directly related to NVS infection. Among the 28 isolates recovered from these patients, 50% were not susceptible to penicillin, 33% were not susceptible to cefotaxime, and 93% were not susceptible to azithromycin. [ABSTRACT FROM AUTHOR]

Data obtained from 1996 to 2002 on 13 patients with Rhizobium radiobacter infections were analyzed. Ten patients (76%) had underlying hematological malignancy or solid- organ cancer. Six patients (46%) had febrile neutropenia during the course of R. radiobacter infection. The majority (54%) of infections were catheter-related bacteremia, and 92% of infections were hospital acquired. All the patients survived. Eighteen isolates were recovered from the 13 patients, and each isolate was susceptible to cefepime, piperacillin-tazobactam, carbapenems, and ciprofloxacin. The pulsed-field gel electrophoresis profiles differed among the isolates recovered from different patients, indicating the absence of nosocomial spread of the organism. [ABSTRACT FROM AUTHOR]

Provides molecular evidence for strain dissemination of the bacterium Penicillium marneffei infection based on the diagnosis of patients in Taiwan. Epidemiology of P. marneffei infections; Susceptibility to antifungal agents; Chromosomal DNA restriction fragment-length polymorphism types; Patterns of randomly amplified polymorphic DNA.

The article confirms the arrival of Klebsiella pneumoniae carbapenemase (KPC)-2 in Taiwan in 2010. It describes the case of a middle-aged businessman in Zhejiang Province in China who was admitted in a hospital after resuscitation for cardiac arrest and was transferred three days later to the intensive care unit (ICU) at National Taiwan University Hospital. It suggests that such infections could become an emerging problem in Taiwan, given the frequency of travel between Taiwan and Zhejiang Province, the epicentre of the KPC-2 endemic in China.

Presents a letter to the editor that focuses on the occurrence of Ceftriaxone resistance in Ciprofloxacin-resistant Salmonella enterica serotype choleraesuis isolates causing recurrent infection.