Muratani Tetsuro, Matsumoto Tetsuro
Department of Urology, School of Medicine, University of Occupational and Environmental Health (UOEH), 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Int J Antimicrob Agents. 2004 Sep;24 Suppl 1:S28-31. doi: 10.1016/j.ijantimicag.2004.02.001.
Escherichia coli accounted for about 80% of organisms in uncomplicated urinary tract infections (UTIs), followed by Staphylococcus spp. especially Staphylococcus saprophyticus, and Proteus mirabilis. Against E. coli isolates from patients with uncomplicated UTI, faropenem was the most effective. Up to 1999, fluoroquinolone-resistant isolates were not observed in patients with uncomplicated UTI, but in 2001 fluoroquinolone-resistant E. coli isolates emerged and accounted for about 8%. Various types of organisms were isolated in patients with complicated UTI. Enterococcus faecalis, E. coli, and Pseudomonas aeruginosa were the three most frequent organisms isolated. These three organisms accounted for 44.6%. Amongst oral agents, faropenem showed the lowest rate of resistance against E. coli followed by cephems. The rates of highly fluoroquinolone-resistant and cefpodoxime-resistant E. coli isolates increased rapidly from 1998 to 2001. Fluoroquinolone-resistant P. aeruginosa isolates accounted for about 40% in 2001. Against this species, amikacin was the most effective antimicrobials among all agents tested. About 17% of Pseudomonas were resistant to carbapenem. Eight milligram per litre of ampicillin inhibited all E. faecalis isolates; about 60% of Enterococcus faecium were resistant to ampicillin. The rates of levofloxacin-resistant isolates of E. faecalis and E. faecium were 38 and 97% respectively. UTIs caused by vancomycin resistant enterococci (VRE) are rare in Japan.
在单纯性尿路感染（UTI）中，大肠杆菌约占病原体的80%，其次是葡萄球菌属，尤其是腐生葡萄球菌，以及奇异变形杆菌。对于单纯性UTI患者分离出的大肠杆菌，法罗培南最为有效。截至1999年，在单纯性UTI患者中未观察到耐氟喹诺酮的分离株，但在2001年出现了耐氟喹诺酮的大肠杆菌分离株，占比约8%。复杂性UTI患者分离出多种病原体。粪肠球菌、大肠杆菌和铜绿假单胞菌是分离出的最常见的三种病原体。这三种病原体占44.6%。在口服药物中，法罗培南对大肠杆菌的耐药率最低，其次是头孢菌素类。从1998年到2001年，耐高氟喹诺酮和耐头孢泊肟的大肠杆菌分离株比例迅速上升。2001年，耐氟喹诺酮的铜绿假单胞菌分离株约占40%。针对该菌种，阿米卡星是所有测试药物中最有效的抗菌药物。约17%的铜绿假单胞菌对碳青霉烯耐药。每升8毫克的氨苄西林可抑制所有粪肠球菌分离株；约60%的屎肠球菌对氨苄西林耐药。粪肠球菌和屎肠球菌对左氧氟沙星的耐药率分别为38%和97%。在日本，由耐万古霉素肠球菌（VRE）引起的UTI很少见。
