[Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (2004)].
From October 2004 to September 2005, we collected the specimen from 319 patients with lower respiratory tract infections in 12 institutions in Japan, and investigated the susceptibilities of isolated bacteria to various antibacterial agents and patients' characteristics. Of 383 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in inflammation, 381 strains were examined. The breakdown of the isolated bacteria were: Staphylococcus aureus 87, Streptococcus pneumoniae 80, Haemophilus influenzae 78, Pseudomonas aeruginosa (non-mucoid) 35, P. aeruginosa (mucoid) 9, Klebsiella pneumoniae 15, Moraxella subgenus Branhamella catarrhalis 30, etc. Of 87 S. aureus strains, those with 2 microg/mL or less of MIC of oxacillin (methicillin-sensitive S. aureus: MSSA) and those with 4 microg/mL or more of MIC of oxacillin (methicillin-resistant S. aureus: MRSA) were 40 (46.0%) and 47 (54.0%) strains, respectively. Against MSSA, imipenem had the most potent antibacterial activity and inhibited the growth of all the strains at 0.063 microg/mL. Against MRSA, vancomycin showed the most potent activity and inhibited the growth of all the strains at 1 microg/mL. Arbekacin (ABK) also showed the potent activity and its MIC90 was 2 microg/mL. Carbapenems showed the most potent activities against S. pneumoniae and inhibited the growth of all the strains at 0.25-0.5 microg/mL. Cefozopran (CZOP) also had a preferable activity (MIC90: 1 microg/mL) and inhibited the growth of all the strains at 2 microg/mL. In contrast, there were high-resistant strains (MIC: 128 microg/mL or more) for ABK (2.5%), erythromycin (37.5%), and clindamycin (38.8%). Against H. influenzae, levofloxacin showed the most potent activity and inhibited the growth of all the strains at 0.125 microg/mL. Meropenem showed the most potent activity against P. aeruginosa (mucoid) and inhibited the growth of all the strains at 2 microg/mL. Against P. aeruginosa (non-mucoid), amikacin (AMK) had the most potent activity and its MIC90 was 4 microg/mL. The activity of CZOP against the non-mucoid type also was preferable and its MIC90 was 8 microg/mL. Against K. pneumoniae, CZOP, cefmenoxime, cefpirome, flomoxef were the most potent activity and inhibited the growth of all the strains at 0.063 microg/mL. Also, all the agents generally showed a potent activity against M. (B.) catarrhalis and the MIC90 of them were 4 microg/mL or less. The approximately half the number (57.0%) of the patients with respiratory infection were aged 70 years or older. Bacterial pneumonia and chronic bronchitis accounted for 50.8% and 23.8% of all the respiratory infection, respectively. The bacteria frequently isolated from the patients with bacterial pneumonia were S. aureus (21.6%), S. pneumoniae (24.7%) and H. influenzae (20.1%). S. aureus (20.9%), S. pneumoniae (16.1%), and H. influenzae (16.1%) also were relatively frequently isolated from the patients with chronic bronchitis. Before the drug administration, the bacteria frequently isolated from the patients were S. pneumoniae (22.3%) and H. influenzae (25.1%). The bacteria relatively frequently isolated from the patients treated with macrolides were P. aeruginosa and the isolation frequency was 43.5%.
Goto
Hajime
H
The First Department of Internal Medicine, Kyorin University School of Medicine.
Takeda
Hideki
H
Kawai
Shin
S
Watanabe
Takashi
T
Okazaki
Mitsuhiro
M
Shimada
Kaoru
K
Nakano
Kunio
K
Yokouchi
Hiroshi
H
Ikemoto
Hideo
H
Mori
Takeshi
T
Igari
Jun
J
Oguri
Toyoko
T
Yamamoto
Makoto
M
Inoue
Hiroshi
H
Nakadate
Toshihide
T
Suwabe
Akira
A
Ashino
Yugo
Y
Gejyo
Fumitake
F
Okada
Masahiko
M
Aoki
Nobuki
N
Kitamura
Nobuko
N
Suzuki
Yasutoshi
Y
Karasawa
Yasuo
Y
Kudo
Koichiro
K
Kobayashi
Nobuyuki
N
Tanaka
Tsukasa
T
Sumitomo
Midori
M
Matsushima
Toshiharu
T
Oka
Mikio
M
Niki
Yoshihiko
Y
Suga
Moritaka
M
Tosaka
Masakazu
M
Kohno
Shigeru
S
Hirakata
Yoichi
Y
Kondou
Akira
A
Matsuda
Junichi
J
Nakano
Michiko
M
Nasu
Masaru
M
Hiramatsu
Kazufumi
K
Oikawa
Satoru
S
D000368:Aged; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D001982:Bronchial Diseases / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D006193:Haemophilus influenzae / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000302:isolation & purification; D008171:Lung Diseases / Q000382:microbiology*; D001936:Moraxella catarrhalis / Q000187:drug effects / Q000302:isolation & purification; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification