Clinicobacteriological datas on 482 aerobic strains of 21 species of bacteria isolated from the various pus, bile and drain collected from 303 patients during recent 3 years from January 1973 to December 1975 at the Department of Surgery of Seoul National University are presented and the literature is reviewed.
The bacterial strains from total. cases consisted, of 132 strains(27%) of gram(+) bacteria and 370 strains(73%) of gram(-) bacteria, which means the strains of gram(-) bacteria was 2.8 times more than that of gram(+) bacteria. Among the 405 strains isolated from the patients who were admitted, the strains of gram(-) bacteria was 5 times more. In the patient with breast abscess or other subcutaneous abscess 89% of isolated strains was gram(+) bacteria and coagulase(+) staphylococcus was the most frequent organism cultured and was recovered in 66% E. coli was the species most frequently isolated from liver abscess, infected, bile, drain after operation for gastroduodenal perforation, drain or infected wound after operation for ileal perforation or after colon surgery and periproctal abscess. Pseudomonas was the species most frequently isolated from burn wound, drain after operation for liver abscess and drain after biliary surgery.
111(32%) cultures were polymicrobial with a mixed enteric flora predominating and only one--of them was pure gram(+) mixed infection. 44% of the periappendiceal abscess after appendiceal perforation showed mixed infection of gram(+) and gram(-) bacteria and gram(+) bacteria was streptococcus in all except one case, therefore early administration of antibiotics for gram (-) bacteria together with penicillin or.Lincocin-seems to be reasonable for the patients with-appendiceal perforation.
Antibiotic sensitivity of gram(-) bacteria was significantly decreased and nearly all gram (-) strains were resistant to ampicillin and most E. coli were also resistant to aminoglycoside antibiotics, such as kanamycin and gentamycin. These findings suggest that ampicillin is useless antibiotic and aminoglycoside antibiotics follow the example of the ampicillin in Korea. Oral administration of kanamycin only for colon preparation and wide topical application of genta-mycin cream on burn wound should be controlled. This increase of resistant strains need the use of new drugs which were developed recently and imported from foreign countries in the expense of high cost, and may, provoke serious life-threatening hospital infection which incid-ence on surgical services is usuallymgreater than on medical services.
|