Ikemoto H, Watanabe K, Mori T, Igari J, Oguri T, Kawaguchi H, Shimizu Y, Matsumiya H, Saito A, Terai T, Inoue H, Nakadate T, Ito C, Yosida T, Tanno Y, Ohno I, Nishioka K, Arakawa M, Igarashi K, Wada K, Okada M, Ozaki K, Aoki N, Kitamura N, Touyama M
Juntendo University School of Medicine.
Jpn J Antibiot. 1997 May;50(5):421-59.
The bacteria isolated from the patients with lower respiratory tract infections were collected by institutions located throughout Japan, since 1981. Ikemoto et al. have been investigating susceptibilities of these isolates to various antibacterial agents and antibiotics, and characteristics of the patients and isolates from them each year. Results obtained from these investigations are discussed. In 23 institutions around the entire Japan, 567 strains of presumably etiological bacteria were isolated mainly from the sputa of 459 patients with lower respiratory tract infections during the period from October 1995 to September 1996. MICs of various antibacterial agents and antibiotics were determined against 74 strains of Staphylococcus aureus, 82 strains of Streptococcus pneumoniae, 104 strains of Haemophilus influenzae, 85 strains of Pseudomonas aeruginosa (non-mucoid strains), 18 strains of Pseudomonas aeruginosa (mucoid strains), 52 strains of Moraxella subgenus Branhamella catarrhalis, 25 strains of Klebsiella pneumoniae etc., and the drug susceptibilities of these strains were assessed except for those strains that died during transportation. 1) S. aureus. S. aureus strains for which MICs of oxacillin (MPIPC) were higher than 4 micrograms/ml (methicillin-resistant S. aureus) accounted for 52.7%. Arbekacin (ABK) showed the most highest activity against S. aureus with MIC80 of 0.5 micrograms/ml. Vancomycin (VCM) showed the next highest activity with MIC80 of 1 microgram/ml. These drugs showed the high activities against MRSA with MIC80S of 1 microgram/ml. 2) S. pneumoniae. Most of drugs tested showed potent activities against S. pneumoniae. Imipenem (IPM) and panipenem (PAPM), carbapenems, showed the most potent activity with MIC80S of 0.063 microgram/ml. Cefotaxime (CTX), cefmenoxime (CMX) and cefpirome (CPR) of cephems showed the next most potent activities with MIC80S of 0.25 microgram/ml. Erythromycin (EM) and clindamycin (CLDM) showed low activities with MIC80S 128 micrograms/ml or high. Among these strains, however, 48.8% and 65.9% of respective strains were quite toward sensitive these agents with MICs of 0.063 microgram/ml. 3) H. influenzae. The activities of all drugs were potent against H. influenzae test with all MICs at 4 micrograms/ml or below. Cefotiam (CTM), CMX, cefditoren (CDTR) and ofloxacin (OFLX) showed the most potent activity with MIC90S to 0.063 microgram/ml. 4) P. aeruginosa. (mucoid strains) IPM and tobramycin (TOB) showed the most potent activity against P. aeruginosa (mucoid strains) with MIC80S of 1 microgram/ml. Ceftazidime (CAZ), cefsulodin (CFS) and carumonam (CRMN) showed next potent activity, with MIC80S of 2 micrograms/ml. The MIC80S of the other drugs ranged from 4 micrograms/ml to 32 micrograms/ml. 5) P. aeruginosa (non-mucoid strains). TOB and ciprofloxacin (CPFX) showed the most potent activities against P. aeruginosa (non-mucoid strains) with MIC80S of 1 microgram/ml. The MIC80 of ampicillin (ABPC) was 128 micrograms/ml in 1994, it was 16 micrograms/ml in 1995. 6) K. pneumoniae. All drugs except ABPC were active against K. pneumoniae. CPR and CRMN showed the most potent activities against K. pneumoniae with MIC80S of 0.063 microgram/ml. The MIC80S of the other drugs ranged from 0.125 microgram/ml to 2 micrograms/ml. 7) M. (B.) catarrhalis. Against M. (B.) catarrhalis, all the drugs showed good activities with MIC80S at 4 micrograms/ml or below. And MICs of all strains were 8 micrograms/ml or below. IPM, OFLX and minocycline (MINO) showed the most potent activity with MIC80S of 0.063 microgram/ml. Also, we investigated year to year changes in the characteristics of patients, their respiratory infectious diseases, and the etiology. Patients' backgrounds were examine for 567 isolates from 459 cases. The examination of age distribution found that the proportion of patients with ages over 60 years was 66.3% of all the patients showing a slight increase over that in 1994. Proportion of differe
自1981年起,日本各地的机构收集了从下呼吸道感染患者中分离出的细菌。池本等人每年都在研究这些分离株对各种抗菌剂和抗生素的敏感性,以及患者和从中分离出的菌株的特征。讨论了这些调查的结果。在全日本的23个机构中,1995年10月至1996年9月期间,主要从459名下呼吸道感染患者的痰液中分离出567株可能的病原菌。测定了74株金黄色葡萄球菌、82株肺炎链球菌、104株流感嗜血杆菌、85株铜绿假单胞菌(非黏液型菌株)、18株铜绿假单胞菌(黏液型菌株)、52株莫拉克斯氏菌属卡他莫拉菌、25株肺炎克雷伯菌等菌株对各种抗菌剂和抗生素的最低抑菌浓度(MIC),并评估了这些菌株的药敏性,但不包括运输过程中死亡的菌株。1)金黄色葡萄球菌。苯唑西林(MPIPC)MIC高于4微克/毫升的金黄色葡萄球菌菌株(耐甲氧西林金黄色葡萄球菌)占52.7%。阿贝卡星(ABK)对金黄色葡萄球菌的活性最高,MIC80为0.5微克/毫升。万古霉素(VCM)的活性次之,MIC80为1微克/毫升。这些药物对耐甲氧西林金黄色葡萄球菌的MIC80S为1微克/毫升,显示出高活性。2)肺炎链球菌。大多数测试药物对肺炎链球菌显示出强效活性。碳青霉烯类的亚胺培南(IPM)和美罗培南(PAPM)活性最强,MIC80S为0.063微克/毫升。头孢菌素类的头孢噻肟(CTX)、头孢甲肟(CMX)和头孢匹罗(CPR)活性次之,MIC80S为0.25微克/毫升。红霉素(EM)和克林霉素(CLDM)活性较低,MIC80S为128微克/毫升或更高。然而,在这些菌株中,分别有48.8%和65.9%的菌株对这些药物相当敏感,MIC为0.063微克/毫升。3)流感嗜血杆菌。所有测试药物对流感嗜血杆菌均有强效活性,所有MIC均在4微克/毫升或以下。头孢替安(CTM)、CMX、头孢妥仑(CDTR)和氧氟沙星(OFLX)活性最强,MIC90S为0.063微克/毫升。(4)铜绿假单胞菌(黏液型菌株)。IPM和妥布霉素(TOB)对铜绿假单胞菌(黏液型菌株)活性最强,MIC80S为1微克/毫升。头孢他啶(CAZ)、头孢磺啶(CFS)和卡芦莫南(CRMN)活性次之,MIC80S为2微克/毫升。其他药物的MIC80S范围为4微克/毫升至32微克/毫升。5)铜绿假单胞菌(非黏液型菌株)。TOB和环丙沙星(CPFX)对铜绿假单胞菌(非黏液型菌株)活性最强,MIC80S为1微克/毫升。氨苄西林(ABPC)在1994年的MIC80为128微克/毫升,199年为16微克/毫升。6)肺炎克雷伯菌。除ABPC外,所有药物对肺炎克雷伯菌均有活性。CPR和CRMN对肺炎克雷伯菌活性最强,MIC80S为0.063微克/毫升。其他药物的MIC80S范围为0.125微克/毫升至2微克/毫升。7)卡他莫拉菌。对于卡他莫拉菌,所有药物均显示出良好活性,MIC80S在4微克/毫升或以下。所有菌株的MIC均在8微克/毫升或以下。IPM、OFLX和米诺环素(MINO)活性最强,MIC80S为0.063微克/毫升。此外,我们还研究了患者特征、呼吸道传染病及其病因的逐年变化。对459例患者的567株分离株进行了患者背景调查。年龄分布检查发现,60岁以上患者占所有患者的比例为66.3%,比1994年略有增加。不同比例……