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Extended-Spectrum β-Lactamase 생성 장내세균의 분리율 및 선별검사

Other Titles
 Prevalence of Extended-spectrum β-lactamase-producing Enterobacteriaceae and Evaluation of Methods for Detection 
 김병립  ;  정석훈  ;  구자영  ;  이경원  ;  정윤섭  ;  정태전  ;  황현용  ;  김미향 
 Korean Journal of Clinical Microbiology (대한임상미생물학회지), Vol.2(1) : 28-39, 1999 
Journal Title
 Korean Journal of Clinical Microbiology (대한임상미생물학회지) 
Issue Date
Enterobacteriaceae ; Extended-spectrum β-lactamase ; TEM ; SHV ; Third generation cephalosporins ; Aztreonam
Background : Increased isolation of extended-spectrum β -lactamase (ESBL)-producing Entero bacteriaceae resistant to third generation cephalosporins and aztreonam has been noted recently. This study was to determine the prevalence of resistance to these drugs and ESBL in Enterobacteriaceae and to evaluate the methods for de tection. Methods:During the period of October, 1997 and March, 1998, a total of 731 clinical isolates of Enterobacteriaceae were collected from patients of the Kosin Medical Center, Pusan, Korea. Antimicrobial susceptibility test by disk diffusion method and double disk synergy test were performed. MICs of β -lactams were determined by agar dilution method. And ESBL genotypes were determined by polymerase chain reaction. Results: About 10% of Escherichia coli isolates and 20% of Klebsiella pneumoniae isolates were intermediate or resistant to the third generation cephalosporins or aztreonam. Sensitivities of cefotaxime, ceftazidime, ceftriaxone and cefpodoxime disks for the detection of ESBL- producing strains of E. coli and K. pneumoniae by NCCLS standards were 100%, respectively, but that of aztreonam disk was 97%. Positive predictive value of the ceftazidime disk was higher than those of other disks. Twenty strains of E. coli, 20 K. pneumoniae, 19 Enterobacter spp., six Citrobacter freundii, and eight Serratia marcescens showed positive results in double disk synergy test. The transconjugant strain of K. pneumoniae K20482 had blaSHV, and remains of transconjugants of ESBL-producing K. pneumoniae, Enterobacter spp. and S. marcescens had blaTEM. Conclusions: In this study, many strains of Enterobacteriaceae isolated in Korea were resistant to third generation cephalosporins and aztreonam. Some of the strains of Enterobacter spp. and S. marcescens as well as E. coli and K. pneumoniae produced ESBL, and majority of these strains had blaTEM. In the detection of ESBL-producing strains of E. coli and K. pneumoniae by NCCLS standards, all of the antimicrobial agent disks tested were useful, but ceftazidime disk was most effective because of its highest positive predictive value.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
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