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1 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 33 ) 2002 JA * 1 * * 1) * 2)

2 34( 34 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb ( ) (75.3%) Staphylococcus aureus Enterococcus faecalis E. faecalis Enterococcus spp. S. aureus Peptostreptococcus spp. Escherichia coli Klebsiella pneumoniae, Pseudomonas aeruginosa E. coli P. aeruginosa, Enterobacter cloacae, Citrobacter freundii, K. pneumoniae Bacteroides fragilis group E. coli 30 MIC 128 m g/ml 3 (10%) Extended spectrum b -lactamases (ESBLs) Vancomycin (VCM) metallo-b-lactamase P. aerugiosa ) I II. 1) (75.3%) Table (68.1%) (65.2%) (62.2%) (83.1%) (84.8%)

3 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 35 ) Table Fig (67.3%) 50 (15.0%) 19 (5.7%) (Fig. 1) 2) 2002 Table % 35.0% 6 12 (Table 3) Staphylococcus spp. Enterococcus spp.

4 36( 36 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table Table Enterococcus spp., Staphylococcus spp. Enterococcus spp. E. faecalis E. faecium Staphylococcus spp. S. aureus (Table 4) Peptostreptococcus spp. (Table 5) 40 E. coli 17 K. pneumoniae 6 P. aeruginosa 5

5 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 37 ) Table Table E. coli 13 P. aeruginosa 8 E. cloacae 6 C. freundii 4 (Table 6) B. fragilis group B. fragils group Peptostreptococcus spp. Enterococcus spp. B. fragilis group (Fig. 2)

6 38( 38 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table Fig ) (Fig. 3) B. fragilis group E. coli (Fig. 4)

7 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 39 ) Fig. 3. Fig. 4.

8 40( 40 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. (Fig. 5) B. fragilis group E. faecalis B. fragilis group (Fig. 6) MRSA S. aureus % (Fig. 7) 4) (1) (Fig. 8) 6 B. fragilis group (20.9%) (18.7%), E.coli (13.6%), (13.2%), Enterococcus spp. (10.1%) E. coli (Fig. 9) Enterococcus spp. (18.5%) (10.9%), (10.6%), P. aeruginosa (9.4%), B. fragilis group (9.4%), E. coli (9.1%) P. aeruginosa, B. fragilis group, E. coli (2) (Fig. 10) E. coli Klebsiella spp Enterococcus spp. E. coli Enterococcus spp. (Fig. 11) Klebsiella spp. Enterobacter spp. (3) (Fig. 12) 6 Enterococcus spp. (21.4%) Staphylococcus spp. (19.6%), B. fragilis group (15.3%) P. aeruginosa (7.1%) 5) Tables 7 25 MIC (1) S. aureus Oxacillin (MPIPC) 16 MIC 2 (Table 7) 2 MIC 0.25 mg/ml m g/ml MRSA Ampicillin (ABPC) MIC 16 m g/ml Vancomycin (VCM) Arbekacin (ABK) MIC 2 mg/ml Teicoplanin (TEIC) MIC 4 m g/ml Gentamicin (GM) 9 MIC 1 m g/ml 7 MIC 64 m g/ml

9 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 41 ) Fig. 5. Fig. 6.

10 42( 42 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Fig. 7. MRSA Fig. 8.

11 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 43 ) Fig. 9. Fig. 10.

12 44( 44 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Fig. 11. Fig. 12.

13 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 45 ) Table 7. Staphylococcus aureus

14 46( 46 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 8. Staphylococcus epidermidis

15 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 47 ) Table 9. Enterococcus faecalis

16 48( 48 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 10. Enterococcus avium

17 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 49 ) Table 11. Enterococcus faecium

18 50( 50 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 12. Enterococcus spp

19 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 51 ) Table 13. Streptococcus spp

20 52( 52 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 14. Escherichia coli

21 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 53 ) Table 15. Klebsiella pneumoniae

22 54( 54 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 16. Enterobacter cloacae

23 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 55 ) Table 17. Morganella morganii

24 56( 56 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 18. Pseudomonas aeruginosa

25 Table 19. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 57 ) Peptostreptococcus prevotii 9 * 2002

26 58( 58 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 20. Peptostreptococcus spp

27 Table 21. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 59 ) Bacteroides fragilis group

28 60( 60 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 22. Bacteroides spp

29 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 61 ) Table 23. Fusobacterium spp

30 62( 62 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 24. Prevotella spp

31 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 63 ) Table 25. Veillonella spp

32 64( 64 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Clindamycin (CLDM) MIC 128 m g/ml (2) S. epidermidis S. epidermidis 7 6 MPIPC MIC 4 m g/ml (Table 8) MIC 8 m g/ml Piperacillin (PIPC) 3 ABPC, GM Fosfomycin (FOM) 2 MPIPC, Tazobactam/Piperacillin (TAZ/PIPC), Flomoxef (FMOX), Cefmenoxim (CMX), Imipenem (IPM), Meropenem (MEPM) CLDM 1 Minocycline (MINO) MIC 0.5 m g/ml Cefazolin (CEZ), Cefotiam (CTM), Cefpirome (CPR), Cefozopran (CZOP) MIC 2 m g/ml (4) Streptococcus spp. Streptococcus spp. 35 TEIC MEPM, VCM, IPM (Table 13) (5) E. coli E. coli 30 MEPM IPM (Table 14) MIC CEZ MIC 32 m g/ml 5 (16.7%) MIC 90 MEPM m g/ml, CPR, Cefepim (CFPM), CZOP, IPM m g/ml PIPC CEZ PIPC MIC m g/ml TAZ/PIPC 2 m g/ml (3) Enterococcus spp. E. faecalis 26 TEIC MIC 0.5 m g/ml IPM, ABPC, VCM, PIPC, TAZ/PIPC MIC 4 m g/ml (Table 9) E. avium 4 TEIC MIC 0.5 m g/ml (Table 10) VCM MIC 2 m g/ml E. faecium 12 VCM TEIC MIC 1 m g/ml (Table 11) Enterococcus spp. 3 IPM, VCM, TEIC Ciprofoxacin (CPFX) Levofoxacin (LVFX) (Table 12) (6) K. pneumoniae K. pneumoniae 9 MIC (Table 15) CTM MIC m g/ml, MIC 90 4 m g/ml b - MIC 90 MEPM Carumonam (CRMN) m g/ml CZOP Aztreonam (AZT) 0.25 m g/ml MIC 90 GM 0.5 m g/ml Amikacin (AMK) 8 m g/ml (7) Enterobacter spp. E. cloacae 8 (Table 16) MEPM, IPM, GM, CFPM, LVFX

33 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 65 ) (8) Morganella morganii M. morganii 1 Table 17 (9) P. aeruginosa P. aeruginosa 13 MIC 90 CPFX 1 m g/ml MEPM, GM 2 m g/ml (Table 18) (10) Peptostreptococcus spp. Peptostreptococcus prevotii 9 MEPM, TEIC, IPM (Table 19) Peptostreptococcus spp. 21 Minocycline (MINO) (Table 20) (11) Bacteroides spp. Bacteroides fragilis group 40 MIC 90 MEPM 1 m g/ml IPM 2 m g/ml, TAZ/PIPC, MINO 4 m g/ml (Table 21) Bacteroides spp. 4 IPM MEPM (Table 22) (12) Fusobacterium spp. Fusobacterium spp. 3 MIC 2 m g/ml (Table 23) (13) Prevottela spp. Prevottela spp. 13 IPM, MEPM (Table 24) (14) Veillonella spp. Veillonella spp. 6 CLDM, CMX, MEPM, CEZ, CPFX ABPC (Table 25) IV ) B. fragilis group ), E.coli 11), Klebsiella spp. Enterococcus spp. Enterococcus spp., Pseudomonas spp. 12), MRSA Staphylococcus spp. E. coli 15 17) VCM, ABK TEIC S. aureus ABK, VCM TEIC GM MINO VCM MIC 4 mg/ml S. aureus, S. epidermidis, E. faecalis Enterococcus spp. E. coli 1990 CEZ 100 m g/ml MIC 10%

34 66( 66 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. 11,13 15) MIC 128 m g/ml 3 (10%) CEZ PIPC MIC TAZ/ PIPC ESBLs CEZ CTM CMZ b - P. aeruginosa IPM 50 m g/ml MIC 20% 24,25) IPM MEPM MIC MIC 16 m g/ml 1 B. fragilis group MIC 100 m g/ml 16 19) Bacteroides spp. Prevotella spp. MRSA Pseudomonas spp. Enterococcus spp. IPM CZOP CAZ VCM ABK VCM, ABK, TEIC metallo-b-lactamase ESBLs CEZ E. coli 1) 1 Jpn. J. Antibiotics 39: , ) 2 Jpn. J. Antibiotics 41: , ) 37: , ) (MRSA) 2: , ) 3: , ) 4: 43 49, ) MRSA 5: , ) Jpn. J. Antibiotics 47: , ) Jpn. J. Antibiotics 47: , ) 24: 40 45, ) Escherichia coli Jpn. J. Antibiotics 49: , ) Pseudomonas aeruginosa Jpn. J. Antibiotics 49: , 1996

35 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 67 ) 13) 1994 Jpn. J. Antibiotics 49: , ) 1995 Jpn. J. Antibiotics 50: , ) 1996 Jpn. J. Antibiotics 52: , ) Bacteroides fragilis group 28: 48 54, ) 29: , ) 30: 36 43, ) 30: , ) 1997 Jpn. J. Antibiotics 53: , ) 1998 Jpn. J. Antibiotics 54: , ) 32: , ) 1999 Jpn. J. Antibiotics 55: , ) 2000 Jpn. J. Antibiotics 55: , ) 2001 Jpn. J. Antibiotics 56: , 2003 BACTERIA ISOLATED FROM SURGICAL INFECTIONS AND ITS SUSCEPTIBILITIES TO ANTIMICROBIAL AGENTS SPECIAL REFERENCES TO BACTERIA ISOLATED BETWEEN APRIL 2002 AND MARCH 2003 NAGAO SHINAGAWA Department of Surgery, Nagoya Midori Municipal Hospital TADATOSHI TAKAYAMA and KOUMEI KATO The Third Department of Surgery, Nihon University, School of Medicine KOICHI HIRATA, TADASHI KATSURAMAKI and MITSUHIRO MUKAIYA The First Department of Surgery, Sapporo Medical University, School of Medicine TAKESHI SATO Department of Surgery, Surugadai Hospital, Nihon University, School of Medicine YASUHIDE USHIJIMA and TOMOHIRO USHIDA Department of Surgery, Saitama National Hospital JIRO YURA Digestive Disease Center, Matsunami General Hospital NAOKI AIKAWA and KAZUHIKO SEKINE Department of Emergency and Critical Care Medicine, School of Medicine, Keio University TADAO MANABE and HIROMITSU TAKEYAMA Nagoya City University Graduate School of Medical Sciences, Department of Gastroenterological Surgery

36 68( 68 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. MASAMITSU HASEGAWA Department of Surgery, Nagoya City Koseiin Hospital NORIAKI TANAKA and HIROMI IWAGAKI Division of Gastroenterological Surgery, Okayama University, School of Medicine MASAAKI TANIGUCHI Department of Surgery, Chita Kosei Hospital KEIJI MASHITA Department of Surgery, Bisai Hospital SYU ISHIKAWA Department of Surgery, Takahama Municipal Hospital AKIRA MIZUNO Department of Surgery, Inabe General Hospital HIROAKI KINOSHITA and KEN MORIMOTO Gastroenterological Surgery, Osaka City University, Graduate School of Medicine SADAYOSHI FUCHIMOTO Department of Surgery, Fukuyama National Hospital HIDEYUKI KIMURA Department of Surgery, Okayama Saiseikai Hospital EIJI KONAGA and HITOSHI TAKEUCHI Department of Surgery, Iwakuni National Hospital TAIJIRO SUEDA and YOSHIO TAKESUE Department of Surgery, Graduate School of Biomedical Sciences, Hiroshima University MIKIO FUJIMOTO Department of Surgery, Fujiidera Municipal Hospital TAKASHI YOKOYAMA and EIZO HIYAMA Department of General Medicine, Hiroshima University, School of Medicine HIROSHI TANIMURA Department of Surgery, Wakayama Rosai Hospital SEIYO IKEDA and YOICHI YASUNAMI Department of Surgery 1, Fukuoka University, School of Medicine HIROKI YAMAUE and HIRONOBU OHNISHI The Second Department of Surgery, Wakayama Medical School YUMIKO SUZUKI Section of Studies, Tokyo Clinical Research Center Tendency of isolated bacteria from infections in general surgery during the period from April 2002 to March 2003 were investigated in a multicenter study in Japan, and the following results were obtained. In this series, 334 strains were isolated from 131 (75.3%) of 174 patients with surgical infections. One hundred and seventy-one strains were isolated from primary infections, and 163 strains were isolated from postoperative infections. From primary infections, anaerobic Gram-positive bacteria were predominant, while aerobic Gram-positive bacteria were predominant from postoperative infections. Among aerobic Gram-positive bacteria, although the isolation rate of Staphylococcus aureus was the highest, followed by that of Enterococcus faecalis

37 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 69 ) from primary infections, the isolation rate of E. faecalis was the highest from postoperative infections. Among anaerobic Gram-positive bacteria, the isolation rate of Peptostreptococcus spp. was the highest from both types of infections. Among aerobic Gram-negative bacteria, Escherichia coli was the most predominantly isolated from primary infections, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa in this order, and from postoperative infections, E. coli was the most predominantly isolated, followed by P. aeruginosa, Enterobacter cloacae, and Citobacter freundii. Among anaerobic Gram-negative bacteria, the isolation rate of Bacteroides fragilis group was the highest from both types of infections. The isolation rate of aerobic Gram-negative bacteria from primary infections and that of aerobic Gram-positive bacteria from postoperative infections were high in the last several years. We noticed no vancomycin-resistant Gram-positive cocci nor P. aeruginosa producing metallob-lactamase. But we noticed cefazolin-resistant E. coli probably producing extended spectrum b -lactamase.

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