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Keimyung Medical Journal 2012;31(1):63-73.
Antimicrobial Drug Susceptibility and Multidrug Resistance of Klebsiella pneumoniae
Klebsiella pneumoniae의 항균제 감수성과 다약제 내성
서성일; 백원기; 서민호
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.
Key Words: Antimicrobial susceptibility, Cefepime, Ceftazidime, ESBL, Imipenem, Levofloxacin, Meropenem

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