Klebsiella pneumoniae의 항균제 감수성과 다약제 내성

Abstract

Klebsiella pneumoniae is one of the main causes of nosocomial infections. A total of 102 Klebsiella pneumoniae isolated from various clinical specimens in a university medical center were tested for antimicrobial drug susceptibility to 23 drugs including ceftazidime, cefepime, imipenem, meropenem and levofloxacin. Klebsiella pneumoniae were most frequently isolated from sputum (46.1%), followed by urine (24.5%), blood (13.7%), wound discharges (5.9%) and etc. All the strains were susceptible to meropenem and its MIC90 was 2 ㎍/mL. Only 3.9% and 6.9% of the strains were resistant to imipenem and cefepime, and their MIC90 were 2 ㎍/mL, 16 ㎍/mL, respectively. The resistance frequencies of doxycycline and tetracycline were 16.7%, and the MIC90 of doxycycline was 32 ㎍/mL. The resistance frequencies of amoxicillin-clavulanic acid, cefoxitin, cefoperazone, ceftazidime, ceftriaxone, aztreonam, netilmicin, amikacin, gentamicin tobramycin, levofloxacin, ofloxacin, ciprofloxacin, trimethoprim-sulfamethoxazole and chloramphenicol were 21.6-42.2%, and their MIC90s were 64 ㎍/mL to more than 512 ㎍/mL. All of the strains were resistant to ampicillin and 63.7% of the strains were resistant to piperacillin. Isolation frequency of multidrug resistant Klebsiella pneumoniae (MDRKP) strains was 30.4% (31 strains), which showed that MDRKP is prevalent. All the MDRKP were multiply resistant to more than 10 drugs. Two (2%) strains of Klebsiella pneumoniae were multiply resistant to 21 drugs. Among 31 MDRKP isolates, isolation frequency of extended-spectrum ß-lactamase (ESBL) phenotype expressing strains were 87.1% (27 strains), which showed ESBL producing Klebsiella pneumoniae is highly prevalent. Continued surveillance of MDRKP-ESBL prevalence and antimicrobial resistance patterns should provide information that is important for initiation of appropriate antibacterial therapy of MDRKP infections.