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[1995年抗微生物药物对从尿路感染患者分离出的病原体的活性比较研究。III. 与前几年敏感性的差异]

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1995). III. Differences in susceptibilities from previous years].

作者信息

Kumamoto Y, Tsukamoto T, Hirose T, Yokoo A, Hikichi Y, Shigeta S, Takahashi T, Shiraiwa Y, Ogiwara M, Yoshida H, Imafuku Y, Murai M, Watanabe K, Uchida H, Kobayashi Y, Matsuda S, Fujime M, Fujita K, Igari J, Oguri T, Kosakai N, Yamaguchi K, Matsumoto T, Kashitani F, Mochida C

机构信息

Department of Urology, Sapporo Medical University, School of Medicine.

出版信息

Jpn J Antibiot. 1997 Apr;50(4):306-410.

PMID:9192248
Abstract

Susceptibilities to various antimicrobial agents were examined for Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa that were isolated from patients with urinary tract infections (UTIs) in 11 hospitals during June, 1995 through May, 1996, and the results were compared with those obtained during the same period in earlier years. 1. Macrolide resistant E. faecalis isolated from uncomplicated UTIs during the latest study period appeared to have increased compared to those in previous study periods. More than 50% of the isolated E. faecalis during the latest study period were resistant to macrolide antibiotics, for the first time in our history. 2. No obvious changes were observed through the years for susceptibilities of S. aureus to various antimicrobial agents. Vancomycin (VCM) showed the highest activity against S. aureus, with MICs below 2 micrograms/ml or below. 3. Among E. coli strains, those with low susceptibilities to quinolones appeared to have increased over the years with MIC90 changed from between 0.125 microgram/ml or below and 0.5 microgram/ml in the 1989-1990 period to between 8 micrograms/ml and 128 micrograms/ml in the latest study period. 4. Klebsiella spp. showed higher resistance to most antimicrobial agents during periods of 1993-1994 and 1994-1995, but somewhat lower resistance during period of 1995-1996. No resistant Klebsiella spp. were detected from uncomplicated UTIs during the latest study period. 5. Among P. aeruginosa isolates from complicated UTIs, resistance isolates to gentamicin appeared to be increasing over the years. Resistant strains to quinolones were isolated at lower frequencies during periods of 1991-1994, but higher frequency was observed in the latest period, and MIC50s were between 0.5 and 4 micrograms/ml during 1991-1994, but were 16-32 micrograms/ml during 1995-1996. These susceptibility changes should be utilized in determining clinical treatments.

摘要

对1995年6月至1996年5月期间从11家医院的尿路感染(UTI)患者中分离出的粪肠球菌、金黄色葡萄球菌、大肠杆菌、克雷伯菌属和铜绿假单胞菌进行了各种抗菌药物的敏感性检测,并将结果与早年同期获得的结果进行了比较。1. 在最近的研究期间,从单纯性UTI中分离出的耐大环内酯类粪肠球菌与之前的研究期间相比有所增加。在最近的研究期间,超过50%的分离出的粪肠球菌对大环内酯类抗生素耐药,这在我们的历史上尚属首次。2. 多年来,金黄色葡萄球菌对各种抗菌药物的敏感性未观察到明显变化。万古霉素(VCM)对金黄色葡萄球菌的活性最高,MIC低于2微克/毫升或更低。3. 在大肠杆菌菌株中,对喹诺酮类药物敏感性低的菌株多年来似乎有所增加,MIC90从1989 - 1990年期间的0.125微克/毫升或更低和0.5微克/毫升之间变化到最近研究期间的8微克/毫升至128微克/毫升之间。4. 克雷伯菌属在1993 - 1994年和1994 - 1995年期间对大多数抗菌药物表现出较高的耐药性,但在1995 - 1996年期间耐药性有所降低。在最近的研究期间,从单纯性UTI中未检测到耐药的克雷伯菌属。5. 在复杂性UTI分离出的铜绿假单胞菌中,对庆大霉素耐药的分离株多年来似乎在增加。对喹诺酮类药物耐药的菌株在1991 - 1994年期间分离频率较低,但在最近期间观察到较高频率,1991 - 1994年期间MIC50在0.5至4微克/毫升之间,但在1995 - 1996年期间为16 - 32微克/毫升。这些敏感性变化应在确定临床治疗中加以利用。

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