Drug susceptibility of isolates from severe postoperative intraperitoneal infections causing multiple organ failure.
OBJECTIVE
To select the most appropriate antibiotic regimens for life-threatening postoperative infections, we obtained isolates from patients with severe postoperative infections over a 12-year-period, and examined their drug susceptibility.


METHODS
The subjects of this study were 55 patients with multiple organ failure (MOF) caused by postoperative infection.


RESULTS
All strains of Methicillin-resistant Staphylococcus aureus (MRSA) were susceptible to Vancomycin (VCM) and Teicoplanin (TEIC). Only 0.3% of all the Pseudomonas aeruginosa strains were resistant to Imipenem (IPM), but 53.6% of the strains from the severe infections were resistant to IPM. On the other hand, there were few P. aeruginosa strains resistant to Meropenem (MEPM), Ceftazidime (CAZ), Ciprofloxacin (CPFX), and Pazufloxacin (PZFX), even among strains isolated from severe infections. The resistant rate of Bacteroides fragilis to Clindamycin (CLDM) was 35.9%, but there were strains resistant to IPM and Panipenem.


CONCLUSIONS
These findings suggest that VCM or TEIC are most appropriate for severe abdominal abscess caused by MRSA, whereas MEPM, CAZ, CPFX, and PZFX are more effective against P. aeruginosa infections. The only antibiotic effective against B. fragilis infections in this study was IPM.
Kusachi
Shinya
S
Third Department of Surgery, Toho University, School of Medicine, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.
Sumiyama
Yoshinobu
Y
Nagao
Jiro
J
Arima
Yoichi
Y
Yoshida
Yuichi
Y
Tanaka
Hidenori
H
Nakamura
Yoichi
Y
Saida
Yoshihisa
Y
Watanabe
Manabu
M
Sato
Junko
J
D018784:Abdominal Abscess / Q000188:drug therapy / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001442:Bacteroides Infections / Q000188:drug therapy; D001441:Bacteroides fragilis / Q000187:drug effects; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D006801:Humans; D008826:Microbial Sensitivity Tests; D009102:Multiple Organ Failure / Q000382:microbiology*; D011183:Postoperative Complications / Q000188:drug therapy / Q000382:microbiology*; D011552:Pseudomonas Infections / Q000188:drug therapy; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D013203:Staphylococcal Infections / Q000188:drug therapy
D000900:Anti-Bacterial Agents