[Clinically isolated bacterii seen in complicated infections].
The spectrum of causative bacterial agents responsible for post-operative infections in the surgical field have dramatically changed with time. This could be due to recent technical progress in bacterial extraction or the result of more effective antibiotics used post-operatively. Nevertheless nosocomial infections including those caused by MRSA still demand our close attention. Commonly extracted bacterii include Staphylococcus spp., E. faecalis, E. coli, Klebsiella spp., E. cloacae, P. aeruginosa and Bacteroides spp., but with regards to pathogenicity, extraction frequency and drug resistance, agents requiring the highest note of caution may be MRSA, P. aeruginosa and Bacteroides spp. MRSA is still the bacterium which makes the most frequent appearance in the clinical field, and the only effective antibiotic to MRSA is vancomycin. In addition, P. aeruginosa is the most common bacterial agent seen in post-operative infections and also the agent to which many of the cephem drugs do not express a high degree of antibacterial effect. Furthermore, about half of the Bacteroides spp. are beta-lactamase-producing strains which deactive the effect of penicillin and cephem drugs within the infection site. A drug which proves effective against E. coli may nevertheless become somewhat ineffective against this agent when found in a mixed infection and if the drug lacks stability against beta-lactamase. Clinically, mixed infections including some or even all the above agents are known to occur, continuously drawing our close attention.
Iwai
S
S
3rd Department Surgery, Nihon University School of Medicine, Tokyo, Japan.
D001439:Bacteroides / Q000201:enzymology; D013293:Enterococcus faecalis / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification; D016106:Methicillin Resistance; D011183:Postoperative Complications / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000382:microbiology*; D013210:Staphylococcus / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D001618:beta-Lactamases / Q000096:biosynthesis
D001618:beta-Lactamases