KMID : 0984720040360030127
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Infection and Chemotherapy 2004 Volume.36 No. 3 p.127 ~ p.131
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Failure of Cephalosporin Treatment for Bloodstream Infection Caused by Apparently Susceptible Klebsiella pneumoniae which Produced DHA-1¥â-Lactamase Induced by Clavulanic Acid
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Kang Cheol-In
Pai Hyun-Joo Kim Sung-Han Kim Hong-Bin Oh Myoung-Don Kim Eui-Chong Choe Kang-Won
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Abstract
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Backgroud : The therapeutic option is limited for the infections caused by organisms producing plasmidmediated AmpC beta-lactamases, incicasingly identified worldwide. Two sporadic patients with bacteremia caused by K pneumoniae possessing an unusual inducible 8 -lactam resistant phenotype were found in a university hospital.
Materials & Methods : We conducted antibiotic susceptibility test according to NCCLS guideline. Also, we characterized 8-lactamase by isoelectric focusing.
Results : DHA-1 gene conferred the resistant phenotype. The patients had experienced treatment failure when treated with extended-spectnim cephalosporin. For the isolates the cephalosporin resistance was induced by clavulanic acid (and cefoxitin).
Conclusion : Theses results suggest that the extended-spectrum cephalosporins might not provide optimal therapeutic option for inducible DHA-1-producing K pneumoniae infection, even when the pathogens are susceptible in vitro.
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KEYWORD
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Klebsiella, ¥â-lactamase, Cephalosporin resistance
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