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Transcription:

Key words: Blood culture, Trend of bacterial isolation, Increasing of staphylococcus, Use of new cephems

(ABPC), Carbenicillin (CBPC), Surbenicillin (SBPC), Piperacillin (PIPC), Cephalexin (CEX), Cefaclor (CCL), Cephalothin (CET), Cefazolin (CEZ), Cefotiam (CTM), Cefoperazone (CPZ), Cefsulodin (CFS), Cefotaxime (CTX), Ceftizoxime (CZX), Ceftazidime (CAZ), Ceftriaxone (CTRX), Cefmetazole (CMZ), Latamoxef (LMOX), Minocycline (MINO), Tiamphenicol (TP), Gentamicin (GM), Tobramycin (TOB), Amikacin (AMK), Erythromycin (EM), Lincomycin (LCM), Fosfomycin (FOM), ST &M(ST)

Table 1. Changes of frequency of bacterial positive cases on blood culture in 1980 to 1983 : Cases that same bacteria was isolated repeatedly were excepted from the total amount. Table 3. Gram positive bacteria isolated from blood culture in 1980 to 1983.

Table 4. Gram negative bacteria isolated from blood culture in 1980 to 1983

Fig. 1 Antimicrobial agents administered within 24hrs before blood culture to bacterial-positive cases

Table 5. Correlation of bacteria isolated from blood culture with the antimicrobial agents administered to patients within 24 hrs before the culture.

Table 6. Antimicrobial agents administered to patients at time of bacterial isolation from blood culture. Table 7. Species of genus Staphylococcus isolated from blood culture.

Fig. 2 Susceptibility distribution of Staphylococcus aureus to Antimicrobial agents. Fig. 3 Susceptibility distribution of coagulase negative Staphylococci to Antimicrobial agents51 strains

Fig. 4 Susceptibility of organisms isolated from blood culture to antimicrobial agents Fig. 5 Susceptibility of organisms isolated from blood culture to antimicrobial agents.

coagulase-negative staphylococcal isolates from blood cultures. J. Clin. Microbiol., 15: 439 5) Marsik, F. J. & Brake, S.: Species identification and susceptibility to 17 antibiotics of coagulase nagative staphylococci isolated from clinical specimens. J. Clin. Microbiol., 15: 640 6) Swenson, F. J. & Rubin, S. J.: Clinical significance of viridans streptococci isolated from blood cultures. J. Clin. Microbiol., 15: 725-727, 1982. 7) Moore, D. F., Hamada, S. S., Marso, E. & Mar- W. J.: Rapid identification and antimi- tin, crobial susceptibility testing of gram negative bacilli from blood cultures by the automicrobic system. J. Clin. Microbiol., 13: 934-939, 1981. 8) Smith, E. G., Pritchard, J. K. & Mccarthy, L. R.: Four-hour presumptive identification of enterobacteriaceae from blood cultures. Am. J. Clin. Pathol., 75: 88-91, 1981. 9) Rogers, D. E.: The changing pattern of lifethreatening microbial disease. New Eng. J. Med., 261: 677-683, 1959. 1) Buchanan, R. E. & Gibbons, N. E.: Bergery's manual of determinative Bacteriology (Eighth edition), 1974. 10) Myerowitz, R. R., Medeiros, A. A. & O'brien, T. F.: Recent experience with bacillemia due to gram-negative organisms. J. Inf. Dis., 124: 239 11) Curtin, J. A., Petersdorf, R. G. & Bennett, I. L.: Pseudomonas bacteremia: Review of ninetyone cases. Ann. Int. Med., 54: 1077-1107, 1961. 4) Eng, R. H. K., Wang, C., Person, A., Kiehn, T. E. & Armstrong, D.: Species identification of

Recent Trend of Organisms Isolated from Blood Cultures Masatoshi KONNO, Sayoko KAWAKAMI*, Ritsuko NONOGUCHI, Akira GOTO & Kimiko UBUKATA Department of Clinical Pathology, Teikyo University, School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, Japan *Central Clinical Laboratory, Teikyo University Hospital Investigations for blood cultures from inpatients at Teikyo University Hospital between Oct. 1980 and Mach 1983 were carried out and the following results were obtained. The incidence of bacterialpositive blood culture has been significantly increasing since Oct. 1981. The species of organisms isolated from the culture with most rapidly increasing frequency were S. aureus and coagulase negative staphylococci. The time that isolation of the above organisms was increased coincided with the introduction to clinical side of new broad spectrum penicillins and cephems, so called third generation antibiotics. Retrospective study of the state of antibiotic administration with reference to the isolated organisms clarified that 86.5% of the bacterial-positive patients had been administered antimicrobial agents within 24hrs before the blood culture, and also 60% of these patients had been administered two or more antimicrobial agents. The majority of strains, 73.8%, were resistant to the antibiotics used to them. Among isolated organisms, sensitive to the antibiotics used intreatment was most frequently exhibited by staphylococci, and the sensitive strains were most frequently isolated from patients give IVH, etc. Sensitive strains were also frequently isolated from patients administered aminoglycosides, which suggested that the relationship of diseases indicating the use of aminoglycosides with the dosage must be re-investigated. As for the third generation cehems, that are now attracting attention, organisms, frequently resistant to these antibiotics, were isolated from the blood of many patients administered with them.

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