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Cho, Yim, Lee, Kim, Seo, Chung, Yong, Jeong, Lee, and Chong: Trends in Isolation and Antimicrobial Susceptibility of Enteropathogenic Bacteria in 2001-2010 at a Korean Tertiary Care Hospital
Original Article

Ann Clin Microbiol 2013;16(1):45-51.

Published online: 5 March 2013

DOI: https://doi.org/10.5145/ACM.2013.16.1.45

Trends in Isolation and Antimicrobial Susceptibility of Enteropathogenic Bacteria in 2001-2010 at a Korean Tertiary Care Hospital

In Joo Cho1, Jisook Yim1, Yangsoon Lee1, 2, Myung Sook Kim1, Youkyung Seo1, Hae-Sun Chung1, Dongeun Yong1, Seok Hoon Jeong1, Kyungwon Lee1, Yunsop Chong1

1Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea

2Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Correspondence: Kyungwon Lee, Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. (Tel) 82-2-2228-2446, (Fax) 82-2-313-0908, (E-mail) leekcp@yuhs.ac

Received 7 September 201219 November 2012       Accepted 30 November 2012

Copyright © 2013 The Korean Society of Clinical Microbiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Background

Trends in the isolation of enteropathogenic bacteria may differ depending on environmental sanitation. The aims of this study were to determine trends in the isolation and antimicrobial resistance patterns of enteropathogenic bacteria over the last 10 years.

Methods

We analyzed stool cultures of Salmonella spp., Shigella spp., Plesiomonas shigelloides, Yersinia spp., Vibrio spp., and Campylobacter spp. collected at Severance Hospital between 2001 and 2010. Antimicrobial susceptibility testing was performed using the disk diffusion method for nontyphoidal Salmonella (NTS) and Campylobacter.

Results

The number of specimens for stool culture significantly increased from 13,412 during 1969-1978 to 60,714 over the past 10 years, whereas the ratio of positive specimens significantly decreased from 12.9% (1,732) to 1.1% (648). The proportion of Salmonella Typhi decreased from 97.2% in 1969-1978 to 0.8% in 2001-2010, whereas the proportion of NTS increased from 2.8% to 99.2%. The proportion of Shigella among all enteric pathogens was over 50% from 1969 to 1983, while only seven strains were isolated from 2001 to 2010, with the exception of one outbreak. Campylobacter is the second most prevalent organism. The rates of susceptibility to am-picillin and cotrimoxazole were 61% and 92%, respe-ctively, for NTS isolated from 2006 to 2010. The ciprofloxacin susceptibility rate was 79.5% for Campylobacter between 2006 and 2010.

Conclusion

The number of isolates of Salmonella Typhi and Shigella significantly decreased, while the proportion of NTS and Campylobacter increased. Con-tinuous monitoring of ciprofloxacin-resistant Campylobacter isolates is necessary.

Keywords: Campylobacter, Enteropathogenic bacteria, Salmonella

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Table 1.
Comparison of trends in isolation of enteropathogenic bacteria at a tertiary-care hospital
  1969-1978 1979-1988 1989-1998 2001-2010
No. of specimen cultured 13,412 37,846 51,441 60,714
No. of positive specimen 1,732 3,503 2,140 648
% of positive specimen 12.9 9.2 4.2 1.1
No. of positive patient 1,677 3,182 1,531 565∗
  Salmonella Typhi 472 469 58 1
  Salmonella Paratyphi-A 18 101 3 2
  Salmonella serogroup B 3 245 564 86
  Salmonella serogroup C 4 108 126 89
  Salmonella serogroup D 5 107 341 157
  Salmonella serogroup E 2 32 55 22
  Salmonella other serogroup 0 40 39 2
    All Salmonella isolates 504 1,102 1,186 359
  Shigella subgroup A 16 5 2 0
  Shigella subgroup B 781 1,246 30 3
  Shigella subgroup C 8 43 0 0
  Shigella subgroup D 234 214 19 95
    All Shigella isolates 1,039 1,508 51 98
  Campylobacter spp. NT 185 239 85
  Yersinia enterocolitica NT 29 18 1
  Vibrio parahaemolyticus 45 96 42 27
  Plesiomonas shigelloides NT 4 11 0

∗ Two enteropathogenic bacteria isolated from 5 patients.

Abbreviation: NT, not tested.

Table 2.
Number of patients with nontyphoidal Salmonella and Campylobacter spp. isolation by month in 2001-2010
Month No. of patient
Nontyphoidal Salmonella (%) Campylobacter (%)
Jan 7 (2.0) 2 (2.4)
Feb 10 (2.8) 1 (1.2)
Mar 26 (7.3) 4 (4.7)
Apr 31 (8.7) 3 (3.5)
May 36 (10.1) 15 (17.6)
Jun 43 (12.1) 14 (16.5)
Jul 43 (12.1) 16 (18.8)
Aug 46 (12.9) 17 (20.0)
Sep 39 (11.0) 2 (2.4)
Oct 32 (9.0) 1 (1.2)
Nov 30 (8.4) 4 (4.7)
Dec 13 (3.7) 6 (7.1)
Total 356 (100) 85 (100)
Table 3.
Number of patients with nontyphoidal Salmonella and Campylobacter by age group
Organism No. of patients by age group (year) Total
≤5 6-9 10-19 20-29 30-39 40-49 50-59 ≥60
Nontyphoidal Salmonella 202 36 10 18 14 14 21 41 356
Campylobacter 16 9 13 19 12 5 8 3 85
Table 4.
Comparison of trends in antimicrobial susceptibility of nontyphoidal Salmonella
Year No. of patients % of isolates susceptible to:
AMP CHL SXT CTX CAZ FQN
1979-1983 211 98 99 100 NT NT NT
1984-1988 337 54 64 98 NT NT NT
1989-1993 420 67 77 90 NT NT NT
1994-1998 865 76 NT 90 98 98 100
2001-2005 210 65 NT 93 99 100 100
2006-2010 141 61 NT 92 96 98 98

Abbreviations: AMP, ampicillin; CHL, chloramphenicol; SXT, cotrimoxazole; CTX, cefotaxime; CAZ, ceftazidime; FQN, ofloxacin (1994-1996), levofloxavin (1997-1998), levofloxacin (2001-2010); NT, not tested.

Table 5.
Comparison of trends in antimicrobial susceptibility of Campylobacter spp.
Antimicrobial agents % of isolates susceptible
1981-1982 (n=29) 1986-1991 (n=127) 1994-1998 (n=138) 2001-2005 (n=41) 2006-2010 (n=39)
Erythromycin 100 NT 92.0 95.1 87.2
Fluoroquinolone∗ NT NT 74.2 53.8 79.5
Ampicillin 83.8 60.6 72.0 82.9 69.2
Cephalothin 0 7.9 8.8 4.9 7.7
Amikacin 86.2 86.3 98.2 97.6 94.9
Gentamicin 86.2 85.6 98.2 90.2 92.3
Tobramycin 82.8 84.1 77.8 85.4 92.3
Cotrimoxazole 64.3 19.2 22.1 4.9 7.7
Tetracycline 76.9 44.5 13.9 12.2 0

∗ Fluoroquinolones used: ofloxacin (1994-1996), levofloxacin (1997-1998) and ciprofloxacin (2001-2010). Abbreviation: NT, not tested.

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