Changing epidemiology and antimicrobial resistance of bacteria causing bacteremia in Taiwan: 2002-2020

Bacteremia is a major health concern, and the rise of antimicrobial resistance (AMR) has worsened its effects. The Taiwan Surveillance of Antimicrobial Resistance (TSAR) program, established in 1998, has monitored bacterial epidemiology and antimicrobial resistance trends. Between 2002 and 2020, 14,539 non-duplicate bacteremia isolates were collected from 29 hospitals. The three most common bacteremia agents were Escherichia coli (31%), Staphylococcus aureus (13.6%), and Klebsiella pneumoniae (12.7%). However, E. coli and Enterococcus faecium were found to be the predominant cause of bacteremia in Taiwan. The alarming increase in vancomycin resistance among E. faecium, rising from 10.0% in 2004 to 47.7% in 2020, presents a therapeutic challenge. Understanding the composition of bacteria causing bacteremia and their prevalence of AMR is crucial for healthcare and research priorities.