Respiratory superinfections after the use of third-generation cephem antibiotics.

This paper is a report on our studies on superinfections in respiratory tract infections treated during the years 1981-1984. The isolated strains of Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus faecalis, Streptococcus faecium and glucose non-fermentative gram-negative rods such as Pseudomonas aeruginosa were resistant to third-generation cephem antibiotics. These organisms proved to be widely distributed in hospitals and were frequently isolated from the sputum, excised lung and cardiac blood. The colonization of the sputum by bacteria in respiratory tract infections before, during and after treatment with third-generation cephem antibiotics revealed a tendency for these organisms to appear after treatment. Among the gram-positive cocci, S. faecium was most resistant to these antibiotics, followed by S. faecalis, S. epidermidis and S. aureus in that order. The incidence of resistant isolates in 1984 exceeded that in 1983, suggesting an annual increase in resistant bacteria.