3 세대 세파계 항생제에 내성인 임상균주의 분포와 PCR 법을 이용한 TEM type beta-lactamase 생산균주의 동정

Compared to the first and second-generation cephalosporins, the third-generation cephalosporins are remarkably stable against hydrolysis by the $\beta$-lactamases produced by aerobic gram-negative bacilli, such as Enterobacteriaceae. Among these bacteria, the most prevalent plasmid-encoded $\beta$-lactamase is TEM-1 $\beta$-lactamase belonging to class A or group 2b. This enzyme is produced constitutively and is principally active against peniciflins and old cephalosporins rather than third-generafion cephalosporins, carbapenems and mmobactams. However, new TEM type $\beta$-lactamases including TEM-9 and TEM-12 evolved through point mutations in a gene encoding $\beta$-lactamase have been discovered from patients during chemotherapy. These $\beta$-lactamases are known to be capable of hydrolyzing most of the third-generatim cephalosporins. To study the prevalence of $\beta$-lactamases from clinical isolates collected in Korea. the minimal inhibitory concentratims(MICs) of several third-generation cephalosporins against 628 clinical isolates were determined by agar dilution methods, and $\beta$-lactamas-producing bacteria were isolated by use of cefinase disc. By polymerase chain reaction (PCR) method, clinical isolates harboring a gene for TEM type $\beta$-lactamase were identified among the $\beta$-lactamase producing strains. Twentiy three percent of the clinical isolates was resistant to the thirdgeneration cephalosporins, and more than 90% of resistant cells produced various $\beta$-lactamases. TFM type $\beta$-lactamases were dominant in gram-negative bacilli, such as Escherichia coli, Klebsiella pneumoniae, Enterobacter species. These results suggest the necessity of the development of new cephalosporins which are stable against $\beta$-lactamases like TEM.