|Title:||Antimicrobial Susceptibilities among Clinical Isolates of Extended- Spectrum Cephalosporin-Resistant Gram-Negative Bacteria in a Taiwanese University Hospital||Authors:||TENG, LEE-JENE
|Keywords:||BETA-LACTAM RESISTANCE;ACINETOBACTER-BAUMANNII;PSEUDOMONAS- AERUGINOSA;NOSOCOMIAL INFECTIONS;CIPROFLOXACIN;SURVEILLANCE||Issue Date:||2002||Journal Volume:||v.49||Journal Issue:||n.1||Start page/Pages:||69-76||Source:||JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY||Abstract:||
Infections caused by Gram-negative bacteria with resistance to extended- spectrum cephalosporins require the identification of effective alternative antimicrobial therapy. To determine the role of other pre- existing or currently available antimicrobial agents in treating infections caused by these multidrug-resistant pathogens, we evaluated the in vitro susceptibilities of these agents in 411 non-duplicate isolates of extended-spectrum cephalosporin-resistant Gram-negative bacteria recovered between January 1999 and December 1999 in a major teaching hospital in Taipei, Taiwan. These isolates included cefotaxime-resistant ( MICs greater than or equal to 2 mg/L) Escherichia coli (66 isolates) and Klebsiella pneumoniae (77 isolates); cefotaxime-resistant (MICs greater than or equal to 64 mg/L) Enterobacter cloacae (59 isolates), Serratia marcescens (52 isolates) and Citrobacter freundii (52 isolates); and ceftazidime-resistant (MICs greater than or equal to 64 mg/L) Pseudomonas aeruginosa (50 isolates) and Acinetobacter baumannii (55 isolates). Overall, carbapenems( imipenem and meropenem) had good activity against the cefotaxime-resistant Enterobacteriaceae tested (>90% of isolates were susceptible). However, carbapenems had limited activity against the ceftazidime-resistant P. aeruginosa ( only 4% of isolates were susceptible ) and A. baumannii (51- 56% of isolates were susceptible). Among the E. coli and K. pneumoniae isolates tested, 33.3% and 58.4%, respectively, exhibited extended-spectrum beta-lactamase phenotype, determined by the double disc method. Over 80% of cefotaxime -resistant E. cloacae and C. freundii were susceptible to cefepime, but this agent had limited activity against other bacteria tested. Susceptibilities of these isolates to ciprofloxacin varied, ranging from 25% for A. baumannii to 92% for E. cloacae. Newer fluoroquinolones (moxifloxacin and trovafloxacin) had equal or less activity against these organisms, except for A. baumannii for which their MIC(90)s( 8-16 mg/L) were four- to 16-fold less than that of ciprofloxacin (MIC90 128 mg/L).
|Appears in Collections:||醫學檢驗暨生物技術學系|
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