Yamaguchi Keizo, Ishii Yoshikazu, Yamanaka Kiyoharu, Watanabe Naoki, Uehara Nobuyuki, Kaku Mitsuo, Okabe Tadashi, Ito Koichi, Nagasawa Mitsuaki, Baba Hisashi, Ichiyama Satoshi, Kurokawa Yukinori, Negayama Kiyoshi, Hirakata Yoichi
Department of Microbiology and Infectious Diseases, School of Medicine, Toho University.
Jpn J Antibiot. 2008 Aug;61(4):241-68.
We conducted 3 nationwide surveillance studies between 2001 and 2005 at 39 participating institutions throughout Japan according to the special survey plan to investigate susceptibility to ciprofloxacin (CPFX) and various parenteral antimicrobials using clinical isolates from patients with severe infection during the reexamination period of parenteral CPFX. Results of the first special survey (2001) were already reported in this journal. The current third special survey (2005) was conducted at 34 participating institutions throughout Japan to determine susceptibility to CPFX and 22 various parenteral antimicrobials with the use of the microdilution method with respect to 1696 strains isolated and identified from various clinical specimens between January and June 2005. The results of CPFX in this survey were compared with those in the first and second special surveys. The minimum inhibitory concentration of CPFX at which 90% of isolates were susceptible (MIC90) ranged from < or =0.063 to 2 microg/mL for methicillin-susceptible Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Moraxella catarrhalis, Haemophilus influenzae, Klebsiella spp., Citrobacter freundii, Enterobacter spp., Proteus spp., Serratia marcescens, and Acinetobacter baumannii, revealing no marked change from results of the first and second surveys. However, the CPFX-susceptibility rate of Escherichia coli decreased in the second and third surveys compared to that in the first survey. For Morganella morganii and Pseudomonas aeruginosa, the MIC90 of CPFX tended to increase with time. The CPFX-susceptibility rates calculated from the pneumonia breakpoint were 85.2% for P. aeruginosa and 67.9% for Stenotrophomonas maltophilia. With the exception of these 2 species, major causative organisms of respiratory tract infection had susceptibility rates as high as 90% or more for CPFX, which were similar to results of the first and second special surveys. These susceptibility rates for CPFX were similar to the rates for cefozopran and imipenem. These values generally indicated favorable CPFX susceptibility testing results of major bacteria and the potent antimicrobial activity of CPFX particularly against Gram-negative bacteria. Further surveillance is required regarding the trend in susceptibility of E. coli, M. morganii, and P. aeruginosa, which tended to become less susceptible with time.
2001年至2005年间，我们依据特别调查计划，在日本全国39家参与机构开展了3项全国性监测研究，旨在利用肠外环丙沙星（CPFX）重新评估期间严重感染患者的临床分离株，调查对CPFX及多种肠外抗菌药物的敏感性。首次特别调查（2001年）的结果已在本期刊发表。本次第三次特别调查（2005年）在日本全国34家参与机构进行，采用微量稀释法，针对2005年1月至6月间从各种临床标本中分离并鉴定出的1696株菌株，测定对CPFX及22种肠外抗菌药物的敏感性。将本次调查中CPFX的结果与首次和第二次特别调查的结果进行比较。对于甲氧西林敏感金黄色葡萄球菌、肺炎链球菌、化脓性链球菌、卡他莫拉菌、流感嗜血杆菌、克雷伯菌属、弗氏柠檬酸杆菌、肠杆菌属、变形杆菌属、粘质沙雷菌和鲍曼不动杆菌，CPFX的90%抑菌浓度（MIC90）范围为≤0.063至2μg/mL，与首次和第二次调查结果相比无明显变化。然而，与首次调查相比，第二次和第三次调查中大肠杆菌对CPFX的敏感率有所下降。对于摩根摩根菌和铜绿假单胞菌，CPFX的MIC90随时间有上升趋势。根据肺炎折点计算的铜绿假单胞菌对CPFX的敏感率为85.2%，嗜麦芽窄食单胞菌为67.9%。除这两个菌种外，呼吸道感染的主要病原菌对CPFX的敏感率高达90%或更高，与首次和第二次特别调查结果相似。这些CPFX的敏感率与头孢唑兰和亚胺培南的敏感率相似。这些数值总体表明主要细菌对CPFX的药敏试验结果良好，且CPFX对革兰氏阴性菌具有强大的抗菌活性。对于大肠杆菌、摩根摩根菌和铜绿假单胞菌随时间敏感性趋于降低的趋势，还需要进一步监测。
