Antibiotic Susceptibility of Enterococcal Isolates causing Bacteremia / 감염

ABSTRACT

BACKGROUND: Enterococci have emerged as an important nosocomial pathogen. Enterococcal infections are a therapeutic challange because of antibiotics resistance, especially high-level aminoglycoside resistance and vancomycin resistance. METHODS: We reviewed the medical records of enterococcal bacteremia patients admitted to Seoul National University Hospital between April 1996 and May 1998. The susceptibility of enterococci to ampicillin, vancomycin, teicoplanin, gentamicin, streptomycin, ciprofloxacin, imipenem, rifampin, and tetracyclin were determined by micro-dilution method. RESULTS: Forty-two episodes of enterococcal bacteremia were identified. Of the 42 bacteremia, 74% (31/42) were caused by E. faecalis, and 26% (11/42) by E. faecium. The most common underlying diseases were hepatobiliary diseases (24%) and cardiovascular diseases (24%). Cholangitis (21%), pneumonia (14%), catheter-related infection (10%), peritonitis (7%), urinary tract infection (7%) were the frequent primary infections for the enterococcal bacteremia. Of the 31 isolates of E. faecalis, 29 (94%) were susceptible to ampicillin, whereas only 36% (4/11) of E. faecium were susceptible to ampicillin. Of the isolates of E. faecalis, 61% (19/31) were highly resistant to gentamicin, 39% (12/31) highly resistant to streptomycin, and 32% (10/31) highly resistant to both gentamicin and streptomycin. Of the isolates of E. faecium, 45% (5/11), 55% (6/11), and 27% (3/11) were highly-resistant to gentamicin, streptomycin, and both gentamicin and streptomycin, respectively. Only one isolate of E. faecium showed resistance to vancomycin. CONCLUSION: Approximately one third of enterococcal blood isolates showed high-level resistance to gentamicin and streptomycin.