[Clinical implications of the O-antigen serovar E and drug resistance in persistent Pseudomonas infection].
We studied bacteriological parameters in patients with persistent Pseudomonas aeruginosa (PA) infection, including distribution of the PA O-antigen serovars, incidence of serovar conversion during treatment and relationship between these serovars and susceptibility to antibiotics. PA was identified using an automated bacterial identification system (Avantage Microbiology Center, Abbot Lab., USA) and the PA O-antigen serovar was performed with a monoclonal serovar diagnostic kit (Mei-Assay Pseudomonas Aeruginosa, Meiji Seika, Tokyo). Antibiotic susceptibility was evaluated by minimum inhibitory concentration according to the NCCLS method. The PA was isolated in 14.7% of the total of 1,900 isolates in our hospital from April, 1987 to March, 1988, and was most frequently isolated from urine specimens (51.9%), followed by sputum (40.0%). The serovar E was isolated in 57 (36.3%) of 157 PA strains tested, followed by the serovar B (21.0%) and G (17.8%). The serovar E was widely distributed in the wards of hematology (55.6%), neurosurgery (54.2%) and urology (42.3%). The serovar E showed high resistance rates to many antibiotics: 62.5% to piperacillin; 58.3%, cefsulodin; 58.3%, cefoperazone; and 70.8%, gentamicin. Serovar conversion during treatment was noticed in 8 of 24 patients with persistent PA infection. Three of 5 patients in whom the serovar had converted to the serovar E died. These results suggest that PA infection with the serovar E, especially with that converting from another serovar is an unfavorable prognostic sign.
Yamashita
M
M
Department of Clinical and Laboratory Science, Fukui Medical School.
Morikawa
K
K
Kuroda
M
M
D001789:Blood Group Antigens; D004352:Drug Resistance, Microbial; D006801:Humans; D011552:Pseudomonas Infections / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000276:immunology
D001789:Blood Group Antigens