Shinagawa Nagao, Taniguchi Masaaki, Hirata Koichi, Furuhata Tomohisa, Mizuguchi Tohru, Osanai Hiroyuki, Yanai Yoshiyuki, Hata Fumitake, Kihara Chikasi, Sasaki Kazuaki, Oono Keisuke, Nakamura Masashi, Shibuya Hitoshi, Hasegawa Itaru, Kimura Masami, Watabe Kosho, Hoshikawa Tsuyoshi, Oshima Hideki, Aikawa Naoki, Sasaki Junichi, Suzuki Masaru, Sekine Kazuhiko, Abe Shinya, Takeyama Hiromitsu, Wakasugi Takehiro, Mashita Keiji, Tanaka Moritsugu, Mizuno Akira, Ishikawa Masakazu, Iwai Akihiko, Saito Takaaki, Muramoto Masayuki, Kubo Shoji, Lee Shigeru, Fukuhara Kenichiro, Kobayashi Yasuhito, Yamaue Hiroki, Hirono Seiko, Takesue Yoshio, Fujiwara Toshiyoshi, Shinoura Susumu, Kimura Hideyuki, Iwagaki Hiromi, Tokunaga Naoyuki, Sueda Taijiro, Hiyama Eiso, Murakami Yoshiaki, Ohge Hiroki, Uemura Kenichiro, Tsumura Hiroaki, Kanehiro Tetsuya, Takeuchi Hitoshi, Tanakaya Kouji, Iwasaki Mitsuhiro
Jpn J Antibiot. 2014 Dec;67(6):339-83.
Bacteria isolated from surgical infections during the period from April 2011 to March 2012 were investigated in a multicenter study in Japan, and the following results were obtained. In this series, 785 strains including 31 strains of Candida spp. were isolated from 204 (78.8%) of 259 patients with surgical infections. Five hundred and twenty three strains were isolated from primary infections, and 231 strains were isolated from surgical site infection. From primary infections, anaerobic Gram-negative bacteria were predominant, followed by aerobic Gram-negative bacteria, while from surgical site infection aerobic Gram-positive bacteria were predominant, followed by anaerobic Gram-negative bacteria. Among aerobic Gram-positive bacteria, the isolation rate of Enterococcus spp. was highest, followed by Streptococcus spp. and Staphylococcus spp., in this order, from primary infections, while Enterococcus spp. was highest, followed by Staphylococcus spp. from surgical site infection. Among aerobic Gram-negative bacteria, Escherichia coli was the most predominantly isolated from primary infections, followed by Klebsiella pneumoniae, Pseudomonas aeruginosa and Enterobacter cloacae, in this order, and from surgical site infection, E. coli was most predominantly isolated, followed by P. aeruginosa, K. pneumoniae, and E. cloacae. Among anaerobic Gram-positive bacteria, the isolation rate of Eggerthella lenta was the highest from primary infections, followed by Parvimonas micra, Collinsella aerofaciens, Lactobacillus acidophilus and Finegoldia magna, and from surgical site infection, E. lenta was most predominantly isolated, followed by P micra and L. acidophilus, in this order. Among anaerobic Gram-negative bacteria, the isolation rate of Bacteroidesfragilis was the highest from primary infections, followed by Bilophila wadsworthia, Bacteroides thetaiotaomicron, Bacteroides uniformis and Bacteroides vulgatus, and from surgical site infection, B. fragilis was most predominantly isolated, followed by Bacteroides caccae, B. thetaiotaomicron, Bacteroides ovatus and B. wadsworthia, in this order. In this series, vancomycin-resistant MRSA (methicillin-resistant Staphylococcus aureus), vancomycin-resistant Enterococcus spp. and multidrug-resistant P. aeruginosa were not observed. We should carefully follow up B. wadsworthia which was resistant to various antimicrobial agents, and also Bacteroides spp. which was resistant to many β-lactams.
在日本的一项多中心研究中,对2011年4月至2012年3月期间从外科感染中分离出的细菌进行了调查,结果如下。在该系列中,从259例外科感染患者中的204例(78.8%)分离出785株菌株,其中包括31株念珠菌属菌株。从原发性感染中分离出523株菌株,从手术部位感染中分离出231株菌株。在原发性感染中,厌氧革兰氏阴性菌占主导地位,其次是需氧革兰氏阴性菌;而在手术部位感染中,需氧革兰氏阳性菌占主导地位,其次是厌氧革兰氏阴性菌。在需氧革兰氏阳性菌中,肠球菌属的分离率最高,其次是链球菌属和葡萄球菌属,在原发性感染中依次如此;而在手术部位感染中,肠球菌属最高,其次是葡萄球菌属。在需氧革兰氏阴性菌中,大肠杆菌在原发性感染中分离得最为主要,其次依次是肺炎克雷伯菌、铜绿假单胞菌和阴沟肠杆菌;在手术部位感染中,大肠杆菌分离得最为主要,其次是铜绿假单胞菌、肺炎克雷伯菌和阴沟肠杆菌。在厌氧革兰氏阳性菌中,迟缓埃格特菌在原发性感染中的分离率最高,其次是微小消化链球菌、产气柯林斯菌、嗜酸乳杆菌和大芬戈尔德菌;在手术部位感染中,迟缓埃格特菌分离得最为主要,其次依次是微小消化链球菌和嗜酸乳杆菌。在厌氧革兰氏阴性菌中,脆弱拟杆菌在原发性感染中的分离率最高,其次是沃兹沃思嗜胆菌、多形拟杆菌、单形拟杆菌和普通拟杆菌;在手术部位感染中,脆弱拟杆菌分离得最为主要,其次依次是粪便拟杆菌、多形拟杆菌、卵形拟杆菌和沃兹沃思嗜胆菌。在该系列中,未观察到耐万古霉素的耐甲氧西林金黄色葡萄球菌(MRSA)、耐万古霉素的肠球菌属和多重耐药的铜绿假单胞菌。我们应仔细追踪对多种抗菌药物耐药的沃兹沃思嗜胆菌,以及对多种β-内酰胺耐药的拟杆菌属。