2001から2002年に分離されたグラム陰性桿菌に対するカルバペネム系薬の抗菌力 Antibacterial activities of carbapenem antibiotics against clinical isolates of gram-negative rods

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2001年10月~2002年2月にかけて川崎市立川崎病院細菌検査室にて各種臨床検体から分離・同定された<I>Pseudomonas aeruginosa, Haemophilus influenzae, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens</I>において4種類のカルバペネム系薬に対する感受性を10<SUB>5</SUB>cfu/well接種の微量液体希釈法にもとづくMIC測定により調査した。<BR>1) <I>P. aeruginosa</I> 95株に対するimipenem (IPM) のMIC<SUB>50</SUB>, MIC<SUB>90</SUB>は2μg/mL, 32μg/mL, panipenem (PAPM) では8μg/mL, 32μg/mL, meropenem (MEPM) では1μg/mL, 8μg/mL, biapenem (BIPM) では1μ9/mL, 16μg/mLであり, 耐性株 (MIC≧16μ9/mL) はIPMで25株 (26.3%), PAPMで39株 (41.1%), MEPMで6株 (6.3%), BIPMでは16株 (16.8%) であった。<BR>2) <I>H. influenzae</I> 47株に対するIPMのMIC<SUB>50</SUB>, MIC<SUB>90</SUB>は1μg/mL, 4μg/mL, PAPMでは1μg/mL, 4μg/mL, MEPMでは0.12μg/mL, 0.5μg/mL, BIPMでは1μg/mL, 8μg/mLであり, 耐性株 (IPM, PAPM, BIPMではMIC≧8μg/mL, MEPMではMIC≧1μg/mL) はIPMで1株 (2.1%), PAPMで3株 (6.4%), BIPMで5株 (10.6%) みられたが, MEPMでは1株もみられなかった。<BR>3) <I>K. pneumoniae, E. cloacae, S. marcescens</I>においてはいずれの薬剤でも耐性株 (MIC≧16μg/mL) はみられなかった。<BR>4) 今回の分離株ではメタロβ-lactamaseを産生する<I>P. aeruginosa</I>は1株もなく, また, 従来の報告と比較してもすべてのカルバペネム系薬で明らかな感受性の低下は認めなかったが, 今後とも本系統薬剤の感受性動向について詳細な検討が必要と考えられる。

The susceptibilities of <I>Pseudomonas aeruginosa, Haemophilus influenzae, Klebsiella pneumoniae, Enterobacter cloacae</I> and <I>Serratia marcescens</I> to four types of carbapenems were examined using the broth micro-dilution method. All strains were isolated from various clinical samples obtained from patients of the Kawasaki Municipal Hospital between October 2001 and February 2002. An inoculum size of 10<SUB>5</SUB> cfu/mL was used.<BR>1. The MIC<SUB>50</SUB>S and MIC<SUB>90</SUB>S of the carbapenem antibiotics against 95 strains of <I>P. aeruginosa</I> were as follows: imipenem (IPM), 2μg/mL for MIC<SUB>50</SUB> and 32μg/mL for MIC<SUB>90</SUB>; panipenem (PAPM), 8μg/mL and 32μg/mL, respectively; meropenem (MEPM), 1μg/mL and 8μg/mL, respectively; and biapenem (BIPM), 1μg/mL and 16μg/mL, respectively. The frequencies of strain resistance to IPM, PAPM, MEPM and BIPM (MIC≥16μg/mL) were 26.3%, 41.1%, 6.3% and 16.8%, respectively.<BR>2. The MIC<SUB>50</SUB>s and MIC<SUB>90</SUB>s of carbapenem antibiotics against 47 strains of <I>H. influenzae</I> were as follows: IPM, 1μg/mL for MIC<SUB>50</SUB> and 4μg/mL for MIC<SUB>90</SUB>; PAPM, 1μg/mL and 4μg/mL, respectively; MEPM, 0.12μg/mL and 0.5μg/mL, respectively; and BIPM, 1μg/mL and 8μg/mL, respectively. The frequencies of strain resistance to IPM, PAPM and BIPM (MIC≥8μg/mL) were 2.1%, 6.4% and 10.6%, respectively. However, strain resistance to MEPM (MIC≥1μg/mL) was not observed.<BR>3. No carbapenem-resistant strains of <I>K. pneumoniae, E. cloacae</I> or <I>S. marcescens</I> were detected.<BR>4. We did not detect any strain of <I>P. aeruginosa</I> that could produce IMP-1 metallo β-lactamase. Although the number of carbapenem-resistant strains of <I>P. aeruginosa</I> did not increase significantly compared with past records, the continuous surveillance of resistance to carbapenem antibiotics in clinical isolates is important.

収録刊行物

  • 日本化学療法学会雜誌 = Japanese journal of chemotherapy

    日本化学療法学会雜誌 = Japanese journal of chemotherapy 51(3), 120-126, 2003-03-25

    Japanese Society of Chemotherapy

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