Pharmacology Laboratories, Taisho Pharmaceutical Co., Ltd., Saitama, Japan.
Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan.
Anaerobe. 2019 Jun;57:86-89. doi: 10.1016/j.anaerobe.2019.04.002. Epub 2019 Apr 2.
Aspiration pneumonia is an infectious disease of the lungs caused by inhalation of saliva or foods, associated with swallowing dysfunction. Therefore, the major causative organisms are oral or gastric bacteria. In this study, we evaluated the antimicrobial susceptibility patterns of the anaerobic bacteria which can cause aspiration pneumonia, Fusobacterium spp., Finegoldia magna, Bacteroides fragilis, Peptostreptococcus spp., Prevotella spp., and Streptococcus milleri group to ceftriaxone, cefmetazole, flomoxef, ampicillin/sulbactam, and ampicillin. We also tested the β-lactamase activities of each of the bacterial strains. Fusobacterium spp. and Finegoldia magna were susceptible to all of the tested antimicrobial drugs, except ampicillin, and showed no β-lactamase activity. The Streptococcus milleri group, Bacteroides fragilis, and Peptostreptococcus spp. showed decreased susceptibility to cefmetazole or flomoxef as compared to the susceptibility levels documented in a previous report. There was one strain of Peptostreptococcus anaerobius which was not susceptible to ampicillin/sulbactam, but also showed no β-lactamase activity, suggesting that this strain harbored a mechanism of resistance other than the production of β-lactamase. The susceptibility of Prevotella spp. to ceftriaxone was also decreased as compared to the susceptibility level documented in a previous report. Furthermore, β-lactamase-positive strains were found even among ceftriaxone-susceptible strains. Elderly persons with swallowing dysfunction carry a risk of recurrent episodes of aspiration pneumonia and repeated use of antibiotics increases the risk of development of antibiotic resistance. In the present study, the antibiotic susceptibilities of some of organisms which can cause aspiration pneumonia were found to be decreased as compared to the susceptibility levels documented in a previous report. Therefore, surveillance of the antimicrobial susceptibility patterns of these bacteria is recommended to prevent the development of resistance.
吸入性肺炎是一种由唾液或食物吸入引起的肺部传染病，与吞咽功能障碍有关。因此，主要病原体是口腔或胃部细菌。在这项研究中，我们评估了可能引起吸入性肺炎的厌氧细菌，如梭菌属、大芬戈尔德菌、脆弱拟杆菌、消化链球菌属、普雷沃菌属和米勒链球菌对头孢曲松、头孢美唑、头孢噻肟、氨苄西林/舒巴坦和氨苄西林的药敏模式。我们还测试了每种细菌株的β-内酰胺酶活性。梭菌属和大芬戈尔德菌对所有测试的抗菌药物均敏感，除了氨苄西林，且没有β-内酰胺酶活性。米勒链球菌、脆弱拟杆菌和消化链球菌属对头孢美唑或头孢噻肟的敏感性较以前的报告中记录的敏感性水平降低。有一株厌氧消化链球菌对氨苄西林/舒巴坦不敏感，但也没有β-内酰胺酶活性，这表明该菌株存在除产生β-内酰胺酶以外的耐药机制。与以前的报告中记录的敏感性水平相比，普雷沃菌属对头孢曲松的敏感性也降低了。此外，甚至在头孢曲松敏感的菌株中也发现了β-内酰胺酶阳性株。有吞咽功能障碍的老年人有反复发生吸入性肺炎的风险，反复使用抗生素会增加产生抗生素耐药性的风险。在本研究中，与以前的报告中记录的敏感性水平相比，一些可能引起吸入性肺炎的病原体的抗生素敏感性降低。因此，建议监测这些细菌的抗生素药敏模式，以防止耐药性的发展。
