title: Nationwide surveillance of antimicrobial susceptibility patterns of pathogens isolated from surgical site infections (SSI) in Japan.
abstract: To investigate the trends of antimicrobial resistance in pathogens isolated from surgical site infections (SSI), a Japanese surveillance committee conducted the first nationwide survey. Seven main organisms were collected from SSI at 27 medical centers in 2010 and were shipped to a central laboratory for antimicrobial susceptibility testing. A total of 702 isolates from 586 patients with SSI were included. Staphylococcus aureus (20.4 %) and Enterococcus faecalis (19.5 %) were the most common isolates, followed by Pseudomonas aeruginosa (15.4 %) and Bacteroides fragilis group (15.4 %). Methicillin-resistant S. aureus among S. aureus was 72.0 %. Vancomycin MIC 2 μg/ml strains accounted for 9.7 %. In Escherichia coli, 11 of 95 strains produced extended-spectrum β-lactamase (Klebsiella pneumoniae, 0/53 strains). Of E. coli strains, 8.4 % were resistant to ceftazidime (CAZ) and 26.3 % to ciprofloxacin (CPFX). No P. aeruginosa strains produced metallo-β-lactamase. In P. aeruginosa, the resistance rates were 7.4 % to tazobactam/piperacillin (TAZ/PIPC), 10.2 % to imipenem (IPM), 2.8 % to meropenem, cefepime, and CPFX, and 0 % to gentamicin. In the B. fragilis group, the rates were 28.6 % to clindamycin, 5.7 % to cefmetazole, 2.9 % to TAZ/PIPC and IPM, and 0 % to metronidazole (Bacteroides thetaiotaomicron; 59.1, 36.4, 0, 0, 0 %). MIC₉₀ of P. aeruginosa isolated 15 days or later after surgery rose in TAZ/PIPC, CAZ, IPM, and CPFX. In patients with American Society of Anesthesiologists (ASA) score ≥3, the resistance rates of P. aeruginosa to TAZ/PIPC and CAZ were higher than in patients with ASA ≤2. The data obtained in this study revealed the trend of the spread of resistance among common species that cause SSI. Timing of isolation from surgery and the patient's physical status affected the selection of resistant organisms.
authors.affiliation: Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan. takesuey@hyo-med.ac.jp
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takesue
authors.forename: Akira
authors.initials: A
authors.lastname: Watanabe
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hanaki
authors.forename: Shinya
authors.initials: S
authors.lastname: Kusachi
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Aikichi
authors.initials: A
authors.lastname: Iwamoto
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Totsuka
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sunakawa
authors.forename: Morimasa
authors.initials: M
authors.lastname: Yagisawa
authors.forename: Junko
authors.initials: J
authors.lastname: Sato
authors.forename: Toyoko
authors.initials: T
authors.lastname: Oguri
authors.forename: Kunio
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sumiyama
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
authors.forename: Isamu
authors.initials: I
authors.lastname: Koyama
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
authors.forename: Toshiro
authors.initials: T
authors.lastname: Konishi
authors.forename: Ryoji
authors.initials: R
authors.lastname: Fukushima
authors.forename: Shiko
authors.initials: S
authors.lastname: Seki
authors.forename: Shun
authors.initials: S
authors.lastname: Imai
authors.forename: Tsunehiro
authors.initials: T
authors.lastname: Shintani
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tsukada
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tsukada
authors.forename: Kenji
authors.initials: K
authors.lastname: Omura
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Mikamo
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Takeyama
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Junzo
authors.initials: J
authors.lastname: Shimizu
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Hirai
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohge
authors.forename: Akio
authors.initials: A
authors.lastname: Kadowaki
authors.forename: Kohji
authors.initials: K
authors.lastname: Okamoto
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yanagihara
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification*; D024881:Drug Resistance, Bacterial; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents