Faculty of Medicine, Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo 1438540, Japan.
Diagn Microbiol Infect Dis. 2011 Apr;69(4):443-8. doi: 10.1016/j.diagmicrobio.2010.10.033.
This antimicrobial resistance surveillance study was performed in 51 medical centers in Japan over an 11-year period. The susceptibilities of 4228 strains including Escherichia coli (491 strains), Klebsiella spp. (462 strains), Enterobacter spp. (459 strains), Citrobacter freundii (358 strains), indole-positive Proteus spp. (386 strains), Serratia spp. (443 strains), Acinetobacter spp. (327 strains), Pseudomonas aeruginosa (473 strains), oxacillin-susceptible Staphylococcus aureus (481 strains), and coagulase-negative staphylococci (CoNS; 348 strains) were tested with 7 β-lactams (cefepime, cefpirome, ceftazidime, cefoperazone/sulbactam, imipenem, and piperacillin for gram-negative bacteria, or oxacillin for gram-positive bacteria). No resistance to these β-lactams (with the exception of ceftazidime) was found in oxacillin-susceptible S. aureus and CoNS. Of the E. coli clinical isolates, 24.6% were resistant to piperacillin, whereas 3.5% or less (cefpirome = 4.5%) were resistant to other β-lactam agents. Klebsiella spp. isolates were more susceptible to imipenem (99.6%), cefepime (98.7%), ceftazidime (98.5%), cefpirome (97.6%), and cefoperazone/sulbactam (97.6%). Isolates of Enterobacter spp., C. freundii, and Serratia spp. were susceptible to imipenem, cefepime, and cefpirome as well. The sensitivities of these organisms against cefepime and cefoperazone/sulbactam were 100%. Acinetobacter spp. isolates were less resistant to cefoperazone/sulbactam (0.6% resistance), imipenem (0.9%), and ceftazidime (2.8%) compared with other β-lactam antibiotics tested. Isolates of P. aeruginosa were more susceptible to piperacillin (9.1% resistance), cefoperazone/sulbactam (9.5%), and cefepime (6.6%) compared with ceftazidime (10.8%), cefpirome (16.3%), and imipenem (23.5%). The proportion of strains resistant to β-lactam antimicrobials has decreased compared with data from 2006 (Diagn. Microbiol. Infect. Dis. 60:177-183), reflecting the reduced consumption of β-lactams in Japan.
这项抗菌药物耐药性监测研究在日本的 51 家医疗中心进行，历时 11 年。对 4228 株包括大肠埃希菌（491 株）、克雷伯菌属（462 株）、肠杆菌属（459 株）、弗劳地枸橼酸杆菌（358 株）、吲哚阳性变形杆菌属（386 株）、沙雷氏菌属（443 株）、不动杆菌属（327 株）、铜绿假单胞菌（473 株）、耐苯唑西林金黄色葡萄球菌（481 株）和凝固酶阴性葡萄球菌（CoNS；348 株）进行了 7 种β-内酰胺类药物（头孢吡肟、头孢匹罗、头孢他啶、头孢哌酮/舒巴坦、亚胺培南和哌拉西林用于革兰氏阴性菌，或苯唑西林用于革兰氏阳性菌）的药敏试验。耐苯唑西林的金黄色葡萄球菌和 CoNS 对这些β-内酰胺类药物（除头孢他啶外）均无耐药性。在大肠埃希菌临床分离株中，24.6%对哌拉西林耐药，而对其他β-内酰胺类药物的耐药率为 3.5%或更低（头孢吡肟=4.5%）。克雷伯菌属分离株对亚胺培南（99.6%）、头孢吡肟（98.7%）、头孢他啶（98.5%）、头孢匹罗（97.6%）和头孢哌酮/舒巴坦（97.6%）更为敏感。肠杆菌属、弗劳地枸橼酸杆菌和沙雷氏菌属的分离株对亚胺培南、头孢吡肟和头孢匹罗也敏感。这些菌对头孢吡肟和头孢哌酮/舒巴坦的敏感性为 100%。与其他β-内酰胺类抗生素相比，鲍曼不动杆菌分离株对头孢哌酮/舒巴坦（0.6%耐药）、亚胺培南（0.9%）和头孢他啶（2.8%）的耐药性较低。铜绿假单胞菌分离株对哌拉西林（9.1%耐药）、头孢哌酮/舒巴坦（9.5%）和头孢吡肟（6.6%）的敏感性高于头孢他啶（10.8%）、头孢吡肟（16.3%）和亚胺培南（23.5%）。与 2006 年的数据相比，耐β-内酰胺类抗菌药物的菌株比例有所下降，这反映了日本β-内酰胺类药物用量的减少。
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