Another look at differences in the susceptibility of Escherichia coli and Klebsiella pneumoniae to cephalothin and cefazolin

Authors
Citation
Lll. Yeh et Cl. Chi, Another look at differences in the susceptibility of Escherichia coli and Klebsiella pneumoniae to cephalothin and cefazolin, INT J ANT A, 17(6), 2001, pp. 521-524
Citations number
14
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Microbiology
Journal title
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
ISSN journal
0924-8579 → ACNP
Volume
17
Issue
6
Year of publication
2001
Pages
521 - 524
Database
ISI
SICI code
0924-8579(200106)17:6<521:ALADIT>2.0.ZU;2-K
Abstract
The significance of in vitro susceptibility tests on Enterobacteriaceae to cephalothin and cefazolin has not been exactly defined in the guidelines of the National Committer for Clinical Laboratory Standards. In the hope of c larifying this confusion. we provide additional information from an ancilla ry study of the Taiwan Surveillance of Antimicrobial Resistance 1998 (TSAR I). There were 505 Escherichia coli and 227 Klebsiella pneumoniae isolates susceptible to cephalothin. reported by 42 participating hospitals. The sus ceptibility of these isolates were re-tested at the Microbial Infections Re ference Laboratory using cefazolin, with the result that 72% of the 252 cep halothin-resistant E. coli isolates and 24% of the 41 cephalothin-resistant K. pneumoniae isolates were found to be susceptible to cefazolin. We furth er surveyed the availability of cephalothin and cefazolin in Pharmacy Depar tments: all of the TSAR I hospitals had cefazolin available in their pharma cies. The resistance rate of E. coli was significantly lower for 12 hospita ls that had cefazolin in both pharmacy and laboratory compared with 11 hosp itals that had cefazolin available in pharmacy but cephalothin in laborator y. In addition, for all the hospitals that had cephalothin available for cl inical use, the resistance rate was twice as low in two hospitals reporting cefazolin susceptibility as in the seven hospitals reporting cephalothin s usceptibility. Our findings suggest that inappropriate selection of cephalo thin and cefazolin for susceptibility testing contribute to inaccurate indi cations of in vivo activity for first generation cephalosporins in the trea tment of E. roil infections. (C) 2001 Elsevier Science B.V. and Internation al Society of Chemotherapy. All rights reserved.