SUSCEPTIBILITY OF ESBL-PRODUCING Escherichia coli AND Klebsiella pneumoniae TO VARIOUS ANTIBACTERIAL AGENTS

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  • NAKAMURA TATSUYA
    Division of Clinical Central Laboratory, Kansai Medical University Hospital
  • KOMATSU MASARU
    Division of Clinical Microbiology, Department of Clinical Pathology, Tenri Hospital

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  • Extended spectrum β-lactamase産生Escherichia coliおよびKlebsiella pneumoniaeの各種抗菌薬に対する薬剤感受性について
  • Extended spectrum ベータ lactamase サンセイ Escherichia coli オヨビ Klebsiella pneumoniae ノ カクシュ コウキンヤク ニ タイスル ヤクザイ カンジュセイ ニ ツイテ

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With the increasing use of broad-spectrum antibacterial agents, the increase in various drug-resistant bacterial strains has become a concern in recent years. Especially, the development of drug-resistance by Enterobacteriaceae which significantly affects therapy and prognosis in sepsis andlower gastrointestinal postoperative infection. The extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae strains isolated in the Surveillance Program of Bacterial Resistance in Kinki region of Japan (SBRK) were supplied between November 2000 and March 2003. The susceptibilities of them to 16 kinds of antimicrobial agents were investigated. The number of them was 48 strains consisting of 36 Escherichia coli strains (75%) and 12 Klebsiella pneumoniae strains (25%). Our focus was on carbapenem and the new quinolone antibacterial agents. Among the 16 major antibacterial agents examined, carbapenem had low MIC50/90 values. Meropenem had a MIC50/90 of 0.03/0.06 μg/ml, followed by biapenem (0.12/0.5), imipenem (0.25/0.5) and panipenem (0.25/0.5). Among cephem, ceftazidime had the lowest MIC50 at 4μg/ml. All four of the cephem agents had a MIC90 of greater than 128μg/ml. Among beta-lactamase inhibitors, tazobactam/piperacillin had the lowest MIC50 at 4μg/ml, and sulbactam/cefoperazone had a MIC50 of 32μg/ml. Among the new quinolones, prulifloxacin had the lowest MIC50 at 1μg/ml, and the other drugs had a MIC50 of 2μg/ml. The resistance rate of ciprofloxacin was 61.1% in E. coli and 16.6% in K. pneumoniae. Comparison of drug-sensitivity to cephem by ESBL-gene type revealed that cefpirome, cefepime and cefozopran had higher MIC50/90 values against the CTX-M group with a MIC50, of greater than 128μg/ml. Ceftazidime and aztreonam had higher MIC50/90 values against the TEM/SHV group than those against the CTX-M group. In the CTX-M group, the MIC50 was 4 and 16μg/ml, respectively.

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