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KMID : 1039620140040010082
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Korean Journal of Family Practice
2014 Volume.4 No. 1 p.82 ~ p.88
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Extended-Spectrum β-Lactamase Spread in Primary Hospitals of Bundang District
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Yoon Jeong-Sook
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Abstract
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Background: Extended-spectrum β-lactamase (ESBL) strains are increasing in infectious occurrence in the population, and they are resistant to nearly all beta lactams. Although only a few university or tertiary hospital reports are found, the reports are not found in primary hospitals which represent the larger community, except previous reports in some areas.
We observed the ESBL strains in primary hospitals in Bundang district.
Methods: The 150 urine specimens in primary hospitals of Bundang were collected. An antimicrobial test was performed by disk diffusion and the Vitek (bioMerieux) test, and the minimum inhibitory concentrations (MICs) were measured by broth microdilution. The ESBL was confi rmed by National Committee for Clinical Laboratory Standards (NCCLS) method and double disk synergy.
Results: Ten of 35 Escherichia coli (29%) revealed ESBL. Ten revealed positive double disk synergy. Nine of them showed increased inhibition zone by NCCLS method. Among 9 isolates, 6 showed in both cefotaxime and ceftazidime, and 3 showed in only ceftazidime. One synergy positive isolate did not show increased inhibition zone by NCCLS method. Two of 8 Klebsiella pneumoniae revealed ESBL. Two isolates both showed increased inhibition zone by NCCLS method and double disk synergy. The MIC was measured. The MIC of antimicrobial resistant ESBL was ≥32 μg/mL (ampicillin), 16 μg/mL to ≥32 μg/mL (amoxicillin/clavulanic acid), ≥4 μg/mL (cefazolin), ≥4 μg/mL (cefotaxime), ≥16 μg/mL (ceftazidime), 16 μg/mL to ≥32 μg/mL (cefepime), 16 μg/mL to ≥32 μg/mL (cefoxitin), ≥16 μg/mL (aztreonam), ≥16 μg/mL (gentamicin), ≥4 μg/mL (ciprofl oxacin), and ≥320 μg/mL (trimethoprim/sulfamethoxazole). Even though ESBL MIC was a susceptible isolates, ESBL MIC was higher than non-ESBL’s.
Conclusion: It was found that ESBL is spread in primary hospitals of Bundang. Further studies are needed in primary hospitals of other regions.
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KEYWORD
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Extended-Spectrum β-Lactamase, Klebsiella pneumoniae, Resistance
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