Fukushima Yasutsugu, Fukushima Fumiya, Kamiya Kuniyoshi, Hayashi Yumeko, Tatewaki Masamitsu, Yamada Issei, Hirata Hirokuni, Sugiyama Kumiya, Ishii Yoshiki, Fukuda Takeshi
Department of Pulmonary Medicine and Clinical Immunology, Dokkyo University School of Medicine, Japan.
Intern Med. 2010;49(14):1333-40. doi: 10.2169/internalmedicine.49.3360. Epub 2010 Jul 15.
To examine the relation between annual trends in the antimicrobial susceptibility of Pseudomonas aeruginosa and drug usage, we compared annual changes in the susceptibility rates of P. aeruginosa clinical isolates during a 4-year period and annual trends in the overall usage of antimicrobials during the same period.
We studied annual trends in MIC(90)/MIC(50), antimicrobial use density (AUD), and antimicrobial susceptibility rates based on clinical breakpoints for 150 strains of P. aeruginosa isolated from respiratory specimens at Dokkyo Medical University Hospital from 2005 through 2008.
The MIC(90)/MIC(50) of antimicrobials effective against P. aeruginosa in years 2005, 2006, 2007, and 2008 were as follows: imipenem, 32/2, 32/1, 8/2, and 16/1 microg/mL; meropenem, 8/1, 8/1, 4/0.5, and 4/0.5 microg/mL; and biapenem, 16/1, 32/0.5, 4/0.5, and 8/0.5 microg/mL, indicating that susceptibility to carbapenems increased slightly. The MIC(90)/MIC(50) was 4/0.25, 2/0.125, 1/0.125, and 2/0.25 microg/mL for ciprofloxacin, 8/4, 8/4, 4/4, and 8/4 microg/mL for amikacin, 64/16, 64/16, 64/16, and 64/16 microg/mL for sulbactam/cefoperazone, 8/2, 16/2, 32/2, and 8/2 microg/mL for ceftazidime, indicating little change. The AUDs of fourth-generation cephalosporins increased from 2005 to 2008 (16.2, 18.4, 28.0, and 23.0), while the AUDs of carbapenems decreased (25.7, 23.7, 10.9, and 12.5).
The decrease in the AUDs of carbapenems was associated with increased susceptibility rates of P. aeruginosa to carbapenem derivatives. A continuous understanding of trends in the resistance of P. aeruginosa and various other pathogens is essential for designing countermeasures against nosocomial infections, including the proper and effective use of antimicrobials.
为研究铜绿假单胞菌抗菌药物敏感性年度变化趋势与药物使用之间的关系，我们比较了4年期间铜绿假单胞菌临床分离株药敏率的年度变化以及同期抗菌药物总体使用的年度趋势。
我们研究了2005年至2008年从独协医科大学医院呼吸道标本中分离出的150株铜绿假单胞菌的MIC(90)/MIC(50)、抗菌药物使用密度（AUD）以及基于临床断点的抗菌药物敏感性率的年度趋势。
2005年、2006年、2007年和2008年对铜绿假单胞菌有效的抗菌药物的MIC(90)/MIC(50)如下：亚胺培南，32/2、32/1、8/2和16/1μg/mL；美罗培南，8/1、8/1、4/0.5和4/0.5μg/mL；比阿培南，16/1、32/0.5、4/0.5和8/0.5μg/mL，表明对碳青霉烯类药物的敏感性略有增加。环丙沙星的MIC(90)/MIC(50)分别为4/0.25、2/0.125、1/0.125和2/0.25μg/mL，阿米卡星为8/4、8/4、4/4和8/4μg/mL，舒巴坦/头孢哌酮为64/16、64/16、64/16和64/16μg/mL，头孢他啶为8/2、16/2、32/2和8/2μg/mL，表明变化不大。第四代头孢菌素的AUD从2005年到2008年有所增加（16.2、1
