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KMID : 0357319800150010019
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Journal of the Korean Society for Microbiology
1980 Volume.15 No. 1 p.19 ~ p.32
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Drug Resistance Patterns of the Bacterial Strains Isolated from Rural Areas and an Urban General Hospital
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李光浩/Rhee, Kwang Ho
金翼祥/申喜燮/車昌龍/李承薰/張友鉉/林定圭/Kim, Ik Sang/Shin, Hee Sup/Cha, Chang Yong/Lee, Seung Hoon/Chang, Woo Hyun/Lim, Jung Kyoo
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Abstract
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Besides the benefits of antimicrobial agents in the control of various infectious diseases, widespread and prolonged use of particular antimicrobial agents has brought about the increase of drug-resistant strains in a community and the profound changes in the pattern of infectious diseases.
In Korea, there are some remote villages where no clinics and drug stores are available and the residents in those areas are assumed to have fewer chances to contact with antimicrobial agents.
In the present study, the differences in susceptibilities to 14 antimicrobial agents between the isolates from rural areas (R) and Seoul National University Hospital (SNUH, H) were studied.
The isolates and their numbers were Staphylococcus aureus , R;55, H;68), Enterococci (R;28, ,H;30), Escherichia coli (R;40, H;40), Enterobacter aerogenes (R;25, H;21) and Klebsiella pneunoniae(R;58, H.6! ).
Minimal inhibitory concentrations ( IIC s) of penicillin, ampicillin, carbenicillin, cephalexin, tetracycline, oxytetracyline, doxvcycline, minocycline, gentamicin, kanamycin, streptomycin, erythromycin,
troleandomycin and co-trimoxazcle were determined by agar dilution method.
I. Comparison of MIC´s and resistant strain Proportions between isolates from SNUH and rural area. MIC´s and/or resistant strain proportions isolates from hi-her than of the isolates from rural areas in the cases of
1. S. aureus to doxycycline, streptomycin, and kanamycin
2. E. coli to penicillin, ampicillin, carbenicillin, tetracycline, oxytetracycline, doxycycline, minocycline, streptomycin, kanamycin, erythromycin, and co-trimoxazole.
3. E. aerogenes to carbenicillin, tetracycline, oxytetracycline, doxycycline, minocycline, streptomycine, kanamycine, gentamycin, and co-trimoxazole.
However, the mean MIC and resistant strain proportion of S. aureus to tetracycline were higher ii isolates from rural areas than in these from SNUH and Enterococci showed no differences in susceptibilities to the antimicrobial agents between isolates from rural areas and from SNUH.
Therefore, in general, differences in susceptibility to these antimicrobial agents between the isolates from rural areas and SNUH were remarkably greater´ and broader in gram negative enteric bacteria.
Multiple drug resistance pattern.
Patterns and incidences of multiple drug resistance were studied with penicillin, ampicillin, tetracycline, cephalexin, gentamicin, streptomycin, kanamycim and co-trimoxazole in Enterococci, E. coli, E. aerogenes and K. pneunoniae.
There appeared significant differences in the incidence of multiply drug-resistant strains and multiple drug resistance patterns between the isolates from SNUH and rural areas in Enterococci, E. coli, E. aerogenes and K. pneumoniae.
However, there was no difference in the incidence of multiply drug-resistant strains between isolates of .S. aureus from SNUH and rural areas but the pattern of multiple resistance of the SNUH strains of S. aureus was diverse, while that of the rural strains was predominantly confined to penicillin-tetracycline combination.
The incidence of multigly drug-resistant strains and diversity of their patterns were the highest in E. coli strains isolated from SNLH and there were no multiply drug resistant strains in Enterococci and K. pneunoniae strains isolated from rural areas.
The number of drug-resistance determinants was also different between the isolates from rural areas and SNUH. Most of the multiply drug-resistant strains of E. coli, E. aerogenes and K. pneumaniae isolated from SNUH were resistant to more than 3 kinds of antimicrobial agents, most frequently to ampicillin, tetracycline and streptomycin, while multiply drug-resistant strains from rural areas were resistant to 2 kinds of antimicrobial agents among ampicillin, tetracycline and streptomycin.
With drug-resistant E. coli strains, resistance to tetracycline which was used most widely since 19:31 was most frequently involved as a part of multiple drug-resistance, followed by resistance to ampicillin and streptomycin. ´This strongly suggests that emergence of drag-restant strains in a community 15 directly dependent on the selective pressure exerted by the antimicrobial agent used.
111. Cross resistance.
Cross resistance of bacteria was studied among tetracycline. penicillin, aminoglycoside and macrolide derivatives by analyzing correlation coefficients of susceptibilities using the least square method. In this study, there were high correlations among the susceptibilities to related derivatives. I appears that the relatively low correlations in susceptibilities present in some cases are due to intrinsic resistance of E. aerogenes to penicillin. Enteroccoci to aminoglycoside and E. coli E. aerogenes and K. pneumoniae to macrolide derivatives.
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