Hachiya Tsutomu, Kubo Keishi, Yanagisawa Hideki
Department of Laboratory Medicine, Shinshu University Hospital.
Jpn J Antibiot. 2004 Apr;57(2):157-71.
We determined the minimum inhibitory concentration (MIC) of various antimicrobial agents against 140 strains of Streptococcus pneumoniae, 131 strains of Haemophilus influenzae and 178 strains of Pseudomonas aeruginosa isolated from respiratory organs in 28 affiliated hospitals in Nagano prefecture between December 2002 and February 2003. The results of this report were as followed: 1. All 140 strains of S. pneumoniae were classified into 3 groups; penicillin-susceptible S. pneumoniae (PSSP) (47.1%), penicillin-intermediate S. pneumoniae (PISP) (43.6%) and penicillin-resistant S. pneumoniae (PRSP) (9.3%). 2. Carbapenems and glycopeptide (vancomycin) had highly potent antimicrobial activity against PISP and PRSP like PSSP. However, some of PISP or PRSP isolates were resistant to cephalosporins and a fluoroquinolone (levofloxacin). 3. All 131 strains ofH. Influenzae were also classified into three groups; ampicillin sensitive H. influenzae (73.3%), beta-lactamase producing ampicillin resistant H. influenzae (BLPAR) (8.4%) and beta-lactamase negative ampicillin resistant H. influenzae (BLNAR) (18.3%). 4. Carbapenems and a fluoroquinolone had highly potent antimicrobial activity against BLPAR and BLNAR. However, there were clear differences among 4 carbapenems for the antimicrobial activity. Ceftriaxone (CTRX) was the most active among cepharosporins in this study. 5. The rate of P. aeruginosa isolates resistant to carbapenems, a fluoroquinolone and aminoglycosides were about 11 to approximately 16%, 15% and 0.6 to approximately 8%, respectively. None of the strains was resistant to all 3 antimicrobial classes, but 3 strains were resistant to combination of 2 classes. 6. The MIC50 and MIC90 values of various antibiotics against S. pneumoniae, H. influenzae and P. aeruginosa were different in all 4 regions. In conclusion, the antimicrobial surveillance programs are important for guiding empiric therapy and for focusing interventional control of antimicrobial resistance in regions and hospitals.
我们测定了2002年12月至2003年2月期间从长野县28家附属医院的呼吸器官分离出的140株肺炎链球菌、131株流感嗜血杆菌和178株铜绿假单胞菌对各种抗菌药物的最低抑菌浓度（MIC）。本报告结果如下：1. 140株肺炎链球菌全部分为3组；青霉素敏感肺炎链球菌（PSSP）（47.1%）、青霉素中介肺炎链球菌（PISP）（43.6%）和青霉素耐药肺炎链球菌（PRSP）（9.3%）。2. 碳青霉烯类和糖肽类（万古霉素）对PISP和PRSP具有与PSSP相似的高效抗菌活性。然而，一些PISP或PRSP分离株对头孢菌素类和一种氟喹诺酮类（左氧氟沙星）耐药。3. 131株流感嗜血杆菌也分为3组；氨苄西林敏感流感嗜血杆菌（73.3%）、产β-内酰胺酶的氨苄西林耐药流感嗜血杆菌（BLPAR）（8.4%）和β-内酰胺酶阴性氨苄西林耐药流感嗜血杆菌（BLNAR）（18.3%）。4. 碳青霉烯类和一种氟喹诺酮类对BLPAR和BLNAR具有高效抗菌活性。然而，4种碳青霉烯类药物的抗菌活性存在明显差异。在本研究中，头孢曲松（CTRX）是头孢菌素类中活性最高的。5. 对碳青霉烯类、一种氟喹诺酮类和氨基糖苷类耐药的铜绿假单胞菌分离株比例分别约为11%至约16%、15%和0.6%至约8%。没有菌株对所有3类抗菌药物耐药，但有3株对2类药物联合耐药。6. 4个地区各种抗生素对肺炎链球菌、流感嗜血杆菌和铜绿假单胞菌的MIC50和MIC90值均不同。总之，抗菌监测计划对于指导经验性治疗以及集中开展地区和医院抗菌药物耐药性的干预控制非常重要。
