[从外科感染中分离出的细菌及其对抗菌药物的敏感性——特别提及2006年4月至2007年3月期间分离出的细菌]

[Bacteria isolated from surgical infections and its susceptibilities to antimicrobial agents--special references to bacteria isolated between April 2006 and March 2007].

作者信息

Shinagawa Nagao, Hirata Koichi, Katsuramaki Tadashi, Mizukuchi Tohru, Ushijima Yasuhide, Ushida Tomohiro, Aikawa Naoki, Yo Kikuo, Mashita Keiji, Ishikawa Syu, Mizuno Akira, Kubo Shoji, Lee Shigeru, Fujimoto Mikio, Higaki Kazuyuki, Taniguchi Katsutoshi, Tsuji Takeshi, Ohnishi Hironobu, Yamaue Hiroki, Kawai Manabu, Takesue Yoshio, Tanaka Noriaki, Iwagaki Hiromi, Takayama Tadatoshi, Sato Takeshi, Kato Koumei, Yura Jiro, Takeyama Hiromitsu, Wakasugi Takehiro, Taniguchi Masaaki, Mizuno Isamu, Kimura Hideyuki, Fuchimoto Sadayoshi, Sueda Taijiro, Hiyama Eiso, Murakami Yoshiaki, Ooge Hiroki, Uemura Kenichiro, Tsumura Hiroaki, Yokoyama Takashi, Takeuchi Hitoshi, Yasui Yoshimasa, Ikeda Seiyo, Yasunami Yoichi, Ryu Shinichiro

机构信息

Department of Surgery, NTT West Tokai Hospital.

出版信息

Jpn J Antibiot. 2008 Jun;61(3):122-71.

PMID:18814799

Abstract

Tendency of isolated bacteria from infections in abdominal surgery during the period from April 2006 to March 2007 were investigated in a multicenter study in Japan, and the following results were obtained. In this series, 474 strains including 23 strains of Candida spp. were isolated from 170 (75.2%) of 226 patients with surgical infections. Two hundred and twenty-six strains were isolated from primary infections, and 224 strains were isolated from postoperative infections. From primary infections, anaerobic Gram-negative bacteria were predominant, followed by aerobic Gram-negative bacteria, while from postoperative infections aerobic Gram-positive bacteria were predominant, followed by anaerobic Gram-negative bacteria. Among aerobic Gram-positive bacteria, the isolation rate of Staphylococcus spp. was higher from postoperative infections, while Enterococcus spp. was higher from primary infections. Among aerobic Gram-negative bacteria, Escherichia coli was the most predominantly isolated from primary infections, followed by Klebsiella pneumoniae, Enterobacter cloacae and Pseudomonas aeruginosa, in this order, and from postoperative infections, P. aeruginosa was the most predominantly isolated, followed by E. coli and E. cloacae. Among anaerobic Gram-negative bacteria, the isolation rate of Bilophila wadsworthia was the highest from primary infections, followed by Bacteroides fragilis and from postoperative infections, B. fragilis was most predominately isolated, followed by Bacteroides caccae, Bacteroides thetaiotaomicron and B. wadsworthia in this order. In this series, we noticed no methicillin-resistant Staphylococcus aureus, nor multidrug-resistant P. aeruginosa. There were three strains of methicillin-resistant coagulase-negative Staphylococcus aureus, but all of them had good susceptibilities against various anti-MRSA antibiotics. We should carefully follow up B. wadsworthia.

摘要

在日本的一项多中心研究中，对2006年4月至2007年3月期间腹部手术感染中分离出的细菌趋势进行了调查，并获得了以下结果。在该系列研究中，从226例手术感染患者中的170例（75.2%）分离出474株菌株，其中包括23株念珠菌属。从原发性感染中分离出226株菌株，从术后感染中分离出224株菌株。原发性感染中，厌氧革兰氏阴性菌占主导，其次是需氧革兰氏阴性菌；而术后感染中，需氧革兰氏阳性菌占主导，其次是厌氧革兰氏阴性菌。在需氧革兰氏阳性菌中，葡萄球菌属从术后感染中的分离率较高，而肠球菌属从原发性感染中的分离率较高。在需氧革兰氏阴性菌中，原发性感染中最常分离出的是大肠埃希菌，其次依次为肺炎克雷伯菌、阴沟肠杆菌和铜绿假单胞菌；术后感染中，最常分离出的是铜绿假单胞菌，其次是大肠埃希菌和阴沟肠杆菌。在厌氧革兰氏阴性菌中，原发性感染中沃兹沃思嗜胆菌的分离率最高，其次是脆弱拟杆菌；术后感染中，最常分离出的是脆弱拟杆菌，其次依次为粪拟杆菌、多形拟杆菌和沃兹沃思嗜胆菌。在该系列研究中，未发现耐甲氧西林金黄色葡萄球菌，也未发现多重耐药铜绿假单胞菌。有3株耐甲氧西林凝固酶阴性金黄色葡萄球菌，但它们对各种抗MRSA抗生素均具有良好的敏感性。我们应密切关注沃兹沃思嗜胆菌。