Konno M, Yoshida S, Inoue M, Shimizu Y, Akizawa K, Uehara N, Takahashi S, Fujita K, Saito Y, Takahashi T
Teikyo University, School of Medicine.
Kansenshogaku Zasshi. 1994 Nov;68(11):1338-51.
In order to investigate penicillin resistance (Pcr) in Streptococcus pneumoniae from clinical sources in Japan, a total 1,127 strains of S. pneumoniae was collected at random from 36 institutions participating to "Working group for Pcr S. pneumoniae" around the country in 1993-1994. These strains were isolated more frequently from sputum (38.2%), throat (31.4%), nasal discharge (16.4%), and otorrhea (5.7%). A small number of isolates from blood (19 strains; 1.8%), cerebrospinal fluid (11 strains; 1.0%), and pleural fluid (2 strains; 0.2%) were included respectively. Patients from whom S. pneumoniae was isolated have mostly been associated with children < or = 12 years of age and adults 60 < or = years olds. These isolates were tested for susceptibility to penicillin G, ampicillin, oxacillin, cefixime, cefdinir, imipenem, panipenem, erythromycin, clindamycin, minocycline, and vancomycin by an agar dilution method using Mueller Hinton agar supplemented with 10% sheep blood. Strains with the MICs > or = 0.125 micrograms/ml for penicillin G were defined as a Pc resistance. Of the 1,127 strains, 471 strains (41.8%) were identified as a Pc resistance. Pcr S. pneumoniae were almost resistant to other beta-lactams, including ampicillin, oxacillin, ceftizoxime, cefixime, cefdinir. Although, the MICs of imipenem and panipenem ragned from 0.004-2.0 micrograms/ml with 2 peaks distributions, these antibiotics inhibited the growth of most of Pcr S. pneumoniae at the lowest concentrations of < or = 0.5 microgram/ml. Only vancomycin resistant strain was not detected in these isolates. Most of the Pcr strains were simultaneously resistant to macrolides and minocycline. Further more, isolation frequencies of Pcr S. pneumoniae in west Japan, were relatively high compared with those of east Japan.
为研究日本临床来源肺炎链球菌的青霉素耐药性（Pcr），1993 - 1994年从全国参与“肺炎链球菌Pcr工作组”的36个机构随机收集了总共1127株肺炎链球菌。这些菌株较多从痰液（38.2%）、咽喉（31.4%）、鼻涕（16.4%）和耳漏液（5.7%）中分离得到。分别还包括少量从血液（19株；1.8%）、脑脊液（11株；1.0%）和胸水（2株；0.2%）中分离的菌株。分离出肺炎链球菌的患者大多为12岁及以下儿童和60岁及以上成年人。采用补充10%羊血的穆勒 - 欣顿琼脂通过琼脂稀释法检测这些分离株对青霉素G、氨苄西林、苯唑西林、头孢克肟、头孢地尼、亚胺培南、帕尼培南、红霉素、克林霉素、米诺环素和万古霉素的敏感性。青霉素G的最低抑菌浓度（MIC）≥0.125微克/毫升的菌株被定义为青霉素耐药。在这1127株菌株中，471株（41.8%）被鉴定为青霉素耐药。Pcr肺炎链球菌几乎对包括氨苄西林、苯唑西林、头孢唑肟、头孢克肟、头孢地尼在内的其他β - 内酰胺类抗生素耐药。虽然亚胺培南和帕尼培南的MIC范围为0.004 - 2.0微克/毫升，呈双峰分布，但这些抗生素在最低浓度≤0.5微克/毫升时能抑制大多数Pcr肺炎链球菌的生长。在这些分离株中未检测到耐万古霉素菌株。大多数Pcr菌株同时对大环内酯类和米诺环素耐药。此外，与日本东部相比，日本西部Pcr肺炎链球菌的分离频率相对较高。
