[下呼吸道传染病患者分离细菌对抗生素的敏感性(2006)]。

The Japanese journal of antibiotics Pub Date : 2013-12-01
Hajime Goto, Hideki Takeda, Shin Kawai, Akira Suwabe, Suguru Watanabe, Mitsuhiro Okazaki, Yugo Ashino, Kaoru Shimada, Nobuki Aoki, Tetsuo Sato, Yasuo Honma, Takeshi Mori, Kouichiro Kudo, Haruhito Sugiyama, Shigemi Kondo, Tsukasa Tanaka, Kenji Kido, Kunihiko Yoshimura, Toyoko Oguri, Makoto Yamamoto, Yoshitaka Nakamori, Hiroshi Inoue, Kohei Yamauchi, Midori Sumitomo, Shigeatsu Endo, Toshihide Nakadate, Mikio Oka, Yoshihiro Kobashi, Naoki Saita, Katsunori Yanagihara, Akira Kondou, Junichi Matsuda, Michiko Nakano, Shigeru Kohno, Satoru Oikawa
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引用次数: 0

摘要

2006年10月至2007年9月,我们采集了日本14家机构356例下呼吸道感染患者的标本,调查了分离菌对各种抗菌药物的敏感性及患者特点。从标本(主要来自痰液)中分离出414株推定为引起感染的细菌,其中407株进行了检查。分离出的细菌有:金黄色葡萄球菌64株、肺炎链球菌96株、流感嗜血杆菌87株、铜绿假单胞菌(非粘液样)52株、铜绿假单胞菌(粘液样)11株、肺炎克雷伯菌20株、卡他莫拉菌44株。64株金黄色葡萄球菌中,莫西林MIC≤2 μ g/ml(甲氧西林敏感金黄色葡萄球菌:MSSA)和莫西林MIC≥4 μ g/ml(耐甲氧西林金黄色葡萄球菌:MRSA)的分别为27株(42.2%)和37株(57.8%)。亚胺培南对MSSA的抑菌活性最强,在0.063 μ g/ml以下抑制了所有菌株的生长。万古霉素和利奈唑胺在1 μ g/ml时对MRSA的抑制作用最强。碳青霉烯类对肺炎链球菌的抑制作用最强,尤其是帕尼培南在0.063 μ g/ml以下对所有菌株的生长均有抑制作用。亚胺培南和法罗培南在0.125和0.5 μ g/ml浓度下均具有较好的抑菌活性。红霉素(45.8%)和克林霉素(20.8%)存在高耐药菌株(MIC > 128 μ g/ml)。左氧氟沙星对流感嗜血杆菌的抑制作用最强,其MIC90≤0.063 μ g/ml。美罗培南对铜绿假单胞菌(P. aeruginosa)的抑菌活性最强,其MIC90为0.5 μ g/ml。妥布霉素对铜绿假单胞菌(P. aeruginosa,非黏液样菌)的抑菌活性最强,MIC90为2 μ g/ml。头孢唑普兰对肺炎克雷伯菌的抑菌活性最强,在0.063 μ g/ml以下抑制了所有菌株的生长。除氨苄西林外,所有抗菌药物对卡他菌均有较强的抗菌活性,MIC90均在2 μ g/ml以下。大约一半(50.6%)的呼吸道感染患者年龄在70岁及以上。细菌性肺炎和慢性支气管炎分别占所有呼吸道感染的49.2%和28.1%。从细菌性肺炎患者中分离出的常见细菌为肺炎链球菌(29.2%)、金黄色葡萄球菌(20.8%)和流感嗜血杆菌(12.9%)。在慢性支气管炎患者中也经常分离到流感嗜血杆菌(25.0%)和铜绿假单胞菌(21.7%)。在使用抗菌药物前,从患者身上分离出的常见细菌为肺炎链球菌(27.5%)和流感嗜血杆菌(22.5%)。大环内酯类药物患者中最常见的细菌是铜绿假单胞菌,其分离率为39.4%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (2006)].

From October 2006 to September 2007, we collected the specimen from 356 patients with lower respiratory tract infections in 14 institutions in Japan, and investigated the susceptibilities of isolated bacteria to various antibacterial agents and patients' characteristics. Of 414 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in infection, 407 strains were examined. The isolated bacteria were: Staphylococcus aureus 64, Streptococcus pneumoniae 96, Haemophilus influenzae 87, Pseudomonas aeruginosa (non-mucoid) 52, P. aeruginosa (mucoid) 11, Klebsiella pneumoniae 20, and Moraxella catarrhalis 44. Of 64 S. aureus strains, those with 2 microg/ml or less of MIC of oxacillin (methicillin-susceptible S. aureus: MSSA) and those with 4 microg/ml or more of MIC of oxacillin (methicillin-resistant S. aureus: MRSA) were 27 (42.2%) and 37 (57.8%) strains, respectively. Against MSSA, imipenem had the most potent antibacterial activity and inhibited the growth of all strains at 0.063 microg/ml or less. Against MRSA, vancomycin and linezolid showed the most potent activity and inhibited the growth of all the strains at 1 microg/ml. Carbapenems showed the most potent activities against S. pneumoniae and in particular, panipenem inhibited the growth of all the strains at 0.063 microg/ml or less. Imipenem and faropenem also had a preferable activity and inhibited the growth of all the strains at 0.125 and 0.5 microg/ml, respectively. In contrast, there were high-resistant strains (MIC: over 128 microg/ml) for erythromycin (45.8%) and clindamycin (20.8%). Against H. influenzae, levofloxacin showed the most potent activity and its MIC90 was 0.063 microg/ml or less. Meropenem showed the most potent activity against P. aeruginosa (mucoid) and its MIC90 was 0.5 microg/ml. Against P. aeruginosa (non-mucoid), tobramycin had the most potent activity and its MIC90 was 2 microg/ml. Against K. pneumoniae, cefozopran was the most potent activity and inhibited the growth of all the strains at 0.063 microg/ml or less. Also, all the antibacterial agents except ampicillin generally showed a potent activity against M. catarrhalis and the MIC90 of them were 2 microg/ml or less. The approximately half the number (50.6%) of the patients with respiratory infection were aged 70 years or older. Bacterial pneumonia and chronic bronchitis accounted for 49.2% and 28.1% of all the respiratory infections, respectively. The bacteria frequently isolated from the patients with bacterial pneumonia were S. pneumoniae (29.2%), S. aureus (20.8%), and H. influenzae (12.9%). H. influenzae (25.0%) and P. aeruginosa (21.7%) also were frequently isolated from the patients with chronic bronchitis. Before the antibacterial agent administration, the bacteria frequently isolated from the patients were S. pneumoniae (27.5%) and H. influenzae (22.5%). The bacteria frequently isolated from the patients treated with macrolides was P. aeruginosa, and its isolation frequently was 39.4%.

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