尿路感染症分離菌に対する経口並びに注射用抗菌薬の抗菌力比較(第17報1995年):その1. 感受性について  [in Japanese] COMPARATIVE STUDIES ON ACTIVITIES OF ANTIMICROBIAL AGENTS AGAINST CAUSATIVE ORGANISMS ISOLATED FROM PATIENTS WITH URINARY TRACT INFECTIONS (1995):I. SUSCEPTIBILITY DISTRIBUTION  [in Japanese]

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1995年6月から翌年5月までの間に全国11施設において,尿路感染症と診断された患者から分離された菌株を供試し, それらの各種抗菌薬に対する感受性を測定した。尿路感染症患者から分離された菌の内訳は, グラム陽性菌が29.8%であり, その約42%はEnterococcus faecalisが占めていた。グラム陰性菌は70.2%であり, 最も多く分離されたのがEscherichia coliであった。これらの菌に対する抗菌薬の効果をみるとE. faecalisに対してはAmpicillin (ABPC), Imipe-nem (IPM) の抗菌力が最も強く, ついでVancomycin (VCM), Piperacillin (PIPC) の順であった。Staphylococcus amusに対して最も強い抗菌力を示したのはVCMで,ついでArbekacin (ABK), Minocycline (MINO) が良好であったが,他の薬剤の抗菌力は弱かった。これらの3薬剤はMRSAに対しても同等の抗菌力を示した。Staphylococcus epidermidisに対する抗菌力はABKが最も強く, ついでMINOが良好であった。94年度に成績の良かったセフェム系薬剤のMIC<SUB>90</SUB>は, 94年度の2~16μg/mlに対し95年度は8~128μg/mlであった。Streptococcus aga-lactiaeに対してはGentamicin (GM)を除きいずれの薬剤も優れた抗菌力を示し, MICが4μg/ml以上を示す菌株はほとんどみられなかった。Citrobacter freundiiに対する抗菌力はIPMが最も強く, ついでGMが強かった。Enterobacter cloacaeに対してもIPMの抗菌力が最も強く1μg/mlですべての菌株の発育を阻止したが, その他の薬剤ではMINOとTosufioxacin (TFLX) を除き抗菌力は弱かった。特にペニシリン系, セフェム系薬剤の抗菌力は弱く, ほとんどの薬剤のMIC<SUB>90</SUB>は256μg/ml以上であった。E. coliに対しては, ペニシリン系薬剤を除くほとんどの薬剤が良好な抗菌力を示した。Klebsiella pneumoniaeに対してもペニシリン系薬剤を除き優れた抗菌力を示した。特にCarumonam (CRMN)の抗菌力が最も強く,0.125μg/ml以下で53株すべての発育を阻止した。K. pneumoniaeに対する抗菌力を94年度の成績と比較すると, いずれの薬剤でも95年度の成績が良好であった。Proteus mirabilisに対する抗菌力はABPCとMINOを除き全般的に良好であり, また94年度にキノロン系薬剤でみられた耐性株(MIC≥256μg/ml)もみられなかった。Pseudomonas aeruginosaに対する抗菌力は全般的に弱く, 最も強かったIPMでもMIC<SUB>90</SUB>の値は8μg/mlであった。Serratia marcescensに対しても全般的に抗菌力は弱く, MIC90でみるとIPMが2μg/ml, CRMNが8μg/mlを示した以外は, すべて16μg/ml以上であった。

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 704 bacterial strains isolated from patients with urinary tract infections (UTIs) in 11 hospitals during the period of June 1995 to May 1996. Of the above bacterial isolates, Gram-positive bacteria accounted for 29.8% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 70.2% and most of them were Escherichia coli. Susceptibilities of several isolated bacteria to antimicrobial agents were as followed;<BR>1. Enterococcus faecalis Ampicillin (ABPC) and imipenem (IPM) showed the highest activities against E. faecalis isolated from patients with UTIs. The MIC<SUB>90</SUB>s of them were 1μg/ml. Vancomycin (VCM) and piperacillin (μ) were also active with the MIC<SUB>90</SUB>s of 2μg/ml and 4μg/ml, respectively. The others had low activities with the MIC<SUB>90</SUB>S of 16μg/ml or above.<BR>2. Staphylococcus aureus including MRSA VCM showed the highest activities against S. aureus isolated from patients with UTIs. Its MIC<SUB>90</SUB> was 1μg/ml against both S. aureus and MRSA. Arbekacin (ABK) was also active with the MIC<SUB>90</SUB> of 2μg/ml. The others except minocycline (MINO) had very low activities with the MIC<SUB>90</SUB>s of 64μg/ml or above.<BR>3. Staphylococcus epidermidis ABK and MINO showed the strongest activities against S. epidermidis isolated from patients with UTIs. The MIC<SUB>90</SUB>s of them were 0.25μg/ml. VCM was also active with the MIC<SUB>90</SUB> of 1μg/ml. The MIC<SUB>90</SUB>s of cephems ranged from 2μg/ml to 16μg/ml in 1994, but they ranged from 8μg/ml to 128μg/ml in 1995. These results indicated that some resistances existed among S. epidermidis to cephems.<BR>4. Streptococcus agalactiae All drugs except gentamicin (GM) were active against S. agalactiae. ABPC, cefmenoxime (CMX), IPM, erythromycin (EM), clindamycin (CLDM) and clarithromycin (CAM) showed the highest activities. The MICs for all strains were lower than 0.125μg/ml. The MIC<SUB>90</SUB>s of the others were 2μg/ml or below.<BR>5. Citrobacter freundii IPM showed the highest activity against C. freundii isolated from patients with UTIs. Its MIC<SUB>90</SUB> was 1μg/ml. GM was also active with the MIC<SUB>90</SUB> of 2μg/ml. Cefpirome (CPR), cefozopran (CZOP) and amikacin (AMK) were also active with the MIC<SUB>90</SUB>s of 4μg/ml. Penicillins and cephems except CMX, CPR and CZOP showed low activities with MIC<SUB>90</SUB>s of 256μg/ml or above.<BR>6. Enterobacter cloacae IPM showed the highest activity against E. cloacae. The MICs for all strains were equal to or lower than 1μg/ml. MINO and tosufloxacin (TFLX) were also active with the MIC<SUB>90</SUB>s of 8μg/ml.Penicillins and cephems except CPR and CZOP showed lower activities with the MIC<SUB>90</SUB>s of 256μg/250(32) THE JAPANESE JOURNAL OF ANTIBIOTICS 50-3 Mar. 1997 ml or above.<BR>7. Escherichia coli Most of antimicrobial agents were active against E. coll. Particularly CPR, CZOP and IPM showed the highest activities against E. coll. The MICs for all strains were equal to or lower than 0.5μg/ml. CMX and TFLX were also active with the MIC<SUB>90</SUB>s of 0.125μg/ml or below. Penicillins were slightly active with MIC<SUB>90</SUB>s of 128μg/ml or above.<BR>8. Klebsiella pneumoniae K. pneumoniae was susceptible to all drugs except penicillins, with MIC<SUB>90</SUB>s of 2μg/ml or below. Carumonam (CRMN) had the strongest activity against K. pneumoniae, the MICs for all strains were equal to or lower than 0.125μg/ml. Comparing with the result of 1994, the sensitivities of K. pneumoniae against all drugs had obviously changed into a better state. For example, the MIC<SUB>90</SUB>s of cephems ranged from 0.25μg/ml to 16μg/ml in 1994, but they were all lower than 2μg/ml in 1995.<BR>9. Proteus mirabilis P. mirabilis was susceptible to a majority of drugs.

Journal

  • The Japanese Journal of Antibiotics

    The Japanese Journal of Antibiotics 50(3), 219-250, 1997

    Japan Antibiotics Research Association

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