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 Original Articles |
| Antimicrobial Susceptibility of Escherichia coli and Klebsiella pneumoniae Blood
Isolates over 5 Years:Influence of Extended-Spectrum Beta-Lactamase-
Producing Organisms |
| Cheol-In Kang, M.D., Dong-Min Kim, M.D., Jong-youn Yi, M.D.*, Wan-Beom Park, M.D., Ki-Deok Lee, M.D.
Hong-Bin Kim, M.D., Myoung-don Oh, M.D., Eui-Chong Kim, M.D.*, and Kang-Won Choe, M.D. |
| Departments of Internal Medicine and Laboratory Medicine*, Seoul National University College of Medicine, Seoul, Korea |
Vol.35 Num.6 (p365~369)
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Background:Escherichia coli and Klebsiella pneumoniae are major Gram-negative pathogens causing bloodstream infection. Antibiotic-resistant mutant strains that produce extended-spectrum beta-lactamase (ESBL) have emerged among E. coli and K. pneumoniae and are increasingly being recognized.
Methods:The database at the Clinical Microbiology Department was retrospectively reviewed in order to identify the patients with E. coli and K. pneumoniae bacteremia. The archived blood isolates of E. coli and K. pneumoniae, isolated and stored from Jan 1998 to Dec 2002, were tested for ESBL production using the NCCLS guidelines and/or double-disk synergy test, and antimicrobial susceptibility by disk diffusion method using NSSCL guidelines.
Results:A total of 1045 strains of E. coli and 535 strains of K. pneumoniae were analyzed. The antimicrobial susceptibility of E. coli strains were as follows; cefotaxime 91%, ceftazidime 93%, imipenem 100%, amikacin 97%, gentamicin 75%, tobramycin 79%, and ciprofloxacin 75%. The antimicrobial susceptibility of K. pneumoniae strains were as follows; cefotaxime, 84%, ceftazidime, 87%, imipenem, 100%, amikacin, 94%, gentamicin, 87%, tobramycin, 84%, and ciprofloxacin, 87%. The overall prevalence of ESBL-producing organisms was 8.6% in E. coli and 14.2% in K. pneumoniae. In ESBL-producing organisms, all strains were susceptible to imipenem, whereas 40% of K. pneumoniae strains and 30% of E. coli strains were susceptible to ciprofloxacin.
Conclusion:The overall prevalence of ESBL-producing organisms was 8.6% in E. coli blood isolates and 14.2% in K. pneumoniae blood isolates. Among the ESBL-producing strains, only 40% of K. pneumoniae strains and 30% of E. coli strains were susceptible to ciprofloxacin. |
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Keywords : Escherichia coli, Klebsiella pneumoniae, Beta-lactamase, Antimicrobial drug resistance |
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