One-day studies of bacteriological cultures of fecal specimens obtained from 409 surgical inpatients at 5 occasions enabled rapid assessment of antibiotic resistance in aerobic and anaerobic bacteria, relevant to abdominal infection. This novel approach to surveillance of drug resistance was tested in a 7-year survey at a surgical department. A distinct correlation between local drug consumption and prevalence of resistant fecal bacteria was recorded for ampicillin and doxycycline. 17 other agents studied showed no such obvious correlations. Huge increases of cefuroxime and metronidazole consumption caused no emergence of drug resistant aerobic and anaerobic fecal bacteria. Imipenem was the only agent tested, which inhibited both the aerobic and anaerobic fecal bacteria of nearly all patients.
The aim of this study was to compare the expression of oxacillin resistance in methicillin-resistant Staphylococcus aureus (MRSA) on Paper Disc Method agar supplemented with 5% defibrinated blood (PDM blood agar) and Mueller-Hinton agar supplemented with 2% NaCl (MH NaCl agar) using different susceptibility tests. Fifty mecA-containing isolates of S. aureus, exhibiting 46 different pulsed-field gel electrophoresis patterns, were comparatively tested using the E test, the single disk diffusion test, and the multipoint inoculation technique, under various culture conditions. The E test incubated at 35 degrees C for 24 h (breakpoint of resistance > or = 2.0 mg/L) detected 94% of the isolates on MH NaCl agar, compared with 28% for PDM blood agar (P < 0.05). The disk diffusion test (breakpoint < 10 mm in diameter) under these incubation conditions detected resistance in 100% of the isolates on MH NaCl agar and in 80% of the isolates on PDM blood agar (P < 0.05). The multipoint technique (breakpoint > or = 1 mg/L), applied at 35 degrees C for 24 h, detected 100% on MH NaCl agar and 46% on PDM blood agar (P < 0.05). Irrespective of the method of susceptibility testing evaluated, MH NaCl agar was superior to PDM blood agar for the detection of oxacillin resistance in mecA-containing S. aureus.
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