|
 |
 Home > Available Issues |
|
|
 Original Articles |
| Antibiotic Susceptibility of Staphylococcus aureus, E. coli, Klebsiella pneumoniae and Pseudomonas aeruginosa Isolated from Blood of Seoul National University Hospital Patients |
| Eui Chong Kim, Mi NA Hut, Kyou Sup Han, Myung Hee Park |
| Department of Clinical Pathology, Seoul National University College of Medicine, Seoul, Korea |
Vol.17 Num.1 (p53~59)
|
|
|
Background : One of the most informative tests of clinical microbiology laboratory is the blood culture. Antibiotics should be administrated in the basis of culture report, but empirically selected until susceptibility results are obtained. Because the resistance rate is increasing recently, physicians should have their own guideline of antibiotic treatment. In this study, the data of antibiotic susceptibility of the common causative pathogens isolated from blood of patients were analyzed.
Methods : Minimal inhibitory concentrations of S. aureus, E coli. K. pneumoniae, and P. aeruginosa isolated from blood of patients in Seoul National University Hospital were measured by microdilution broth method. The isolates tested were 24 strains of methicillin-susceptible S. aureus (MSSA), 18 MRSA. 87 E. coli, 53 K. pneumoniae, and 19 P. aeruginosa.
Results : The proportion of MRSA was 42.9% among the patients with S. aureus bacteremia. All of MRSA strains were resistant to imipenem, gentamicin, and ofloxacin, but susceptible to vancomycin and teicoplanin. Twenty nine percent of MSSA strains were resistant to gentamicin, but all of these strains were susceptible to cefazoline and imipenem. There was no MRSA infection in the patients with community-acquired bacteremia. The resistance rates of E. coli against ampicillin and cefazoline were 61% and 14%, respectively. Twenty three percent of K. pneumoniae strains were resistant to cefazoline. In the case of P. aeruginosa, the resistance rate of piperacillin was 21%, but that of ticarcillin/clavulanic acid was 42%. The susceptibility rates of P. aeruginosa against imipenem, gentamicin, and amikacin were 90%, 84% and 90%, respectively.
Conclusion : Oral ß-lactams and gentamicin are recommended for the treatment of patients with community-acquired bacteremia due to S. aureus. But the patients with nosocomial infection by S. aureus may be empirically treated with vancomycin. If the sources of bacteremia can be predicted as urinary tract, biliary tract or intestinal infections, the first generation of cephalosporin is recommended instead of ampicillin. The initial therapy for bacteremia due to P. aeruginosa is the combination of piperacillin and tobramycin until the susceptibility result is reported. |
|
|
Keywords : Bacteremia, S. aureus, E. coli, P. aeruginosa, K. pneumoniae, Antibiotic suseptibility |
|
|
|
|
|
|
|
|
