THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 33( 33 ) 2002 JA * 1 * 2 2003 12 15 * 1) * 2)

34( 34 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. 1982 7 2002 (2002.4 2003.3) 1 174 131 (75.3%) 334 171 163 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 1982 7 1 25) 2002 2002 4 2003 3 I. 25 2002 12 II. 1) 2002 174 131 (75.3%) 334 18 Table 1 91 62 (68.1%) 23 15 (65.2%) 37 23 (62.2%) 83 69 (83.1%) 46 39 (84.8%)

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 35( 35 ) Table 1. 2002 Fig. 1. 2002 225 (67.3%) 50 (15.0%) 19 (5.7%) (Fig. 1) 2) 2002 Table 2 171 163 27.5% 35.0% 6 12 (Table 3) 43 57 Staphylococcus spp. Enterococcus spp.

36( 36 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 2. 2002 Table 3. 2002 Enterococcus spp., Staphylococcus spp. Enterococcus spp. E. faecalis E. faecium Staphylococcus spp. S. aureus (Table 4) 47 22 Peptostreptococcus spp. (Table 5) 40 E. coli 17 K. pneumoniae 6 P. aeruginosa 5

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 37( 37 ) Table 4. 2002 Table 5. 2002 48 E. coli 13 P. aeruginosa 8 E. cloacae 6 C. freundii 4 (Table 6) 41 36 B. fragilis group 18 22 B. fragils group Peptostreptococcus spp. Enterococcus spp. B. fragilis group (Fig. 2)

38( 38 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 6. 2002 Fig. 2. 2002 3) (Fig. 3) 1980 1990 B. fragilis group E. coli (Fig. 4)

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 39( 39 ) Fig. 3. Fig. 4.

40( 40 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. (Fig. 5) 1990 1995 1990 1990 B. fragilis group E. faecalis B. fragilis group (Fig. 6) MRSA 1991 1998 S. aureus 1996 60% (Fig. 7) 4) (1) (Fig. 8) 6 B. fragilis group (20.9%) (18.7%), E.coli (13.6%), (13.2%), Enterococcus spp. (10.1%) 1982 1991 E. coli 6 330 (Fig. 9) Enterococcus spp. (18.5%) (10.9%), (10.6%), P. aeruginosa (9.4%), B. fragilis group (9.4%), E. coli (9.1%) 1992 1996 P. aeruginosa, B. fragilis group, E. coli (2) (Fig. 10) E. coli Klebsiella spp. 1992 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 14 128 m g/ml MRSA Ampicillin (ABPC) 16 14 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

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 41( 41 ) Fig. 5. Fig. 6.

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

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 43( 43 ) Fig. 9. Fig. 10.

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

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 45( 45 ) Table 7. Staphylococcus aureus 16 2002

46( 46 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 8. Staphylococcus epidermidis 7 2002

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 47( 47 ) Table 9. Enterococcus faecalis 26 2002

48( 48 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 10. Enterococcus avium 4 2002

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 49( 49 ) Table 11. Enterococcus faecium 12 2002

50( 50 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 12. Enterococcus spp. 3 2002

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 51( 51 ) Table 13. Streptococcus spp. 35 2002

52( 52 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 14. Escherichia coli 30 2002

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 53( 53 ) Table 15. Klebsiella pneumoniae 9 2002

54( 54 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 16. Enterobacter cloacae 8 2002

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 55( 55 ) Table 17. Morganella morganii 1 2002

56( 56 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 18. Pseudomonas aeruginosa 13 2002

Table 19. THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 57( 57 ) Peptostreptococcus prevotii 9 * 2002

58( 58 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 20. Peptostreptococcus spp. 21 2002

Table 21. THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 59( 59 ) Bacteroides fragilis group 40 2002

60( 60 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 22. Bacteroides spp. 4 2002

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 61( 61 ) Table 23. Fusobacterium spp. 3 2002

62( 62 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Table 24. Prevotella spp. 13 2002

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 63( 63 ) Table 25. Veillonella spp. 6 2002

64( 64 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. Clindamycin (CLDM) 16 14 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 0.063 m g/ml, CPR, Cefepim (CFPM), CZOP, IPM 0.125 m g/ml PIPC CEZ PIPC MIC 90 128 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 50 0.25 m g/ml, MIC 90 4 m g/ml b - MIC 90 MEPM Carumonam (CRMN) 0.125 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

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 65( 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. 1982 7 1994 13) B. fragilis group 1990 10), 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%

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: 2557 2578, 1986 2) 2 Jpn. J. Antibiotics 41: 361 389, 1988 3) 37: 731 743, 1989 4) (MRSA) 2: 232 240, 1990 5) 3: 103 108, 1991 6) 4: 43 49, 1992 7) MRSA 5: 105 111, 1993 8) Jpn. J. Antibiotics 47: 493 501, 1994 9) Jpn. J. Antibiotics 47: 1329 1343, 1994 10) 24: 40 45, 1995 11) Escherichia coli Jpn. J. Antibiotics 49: 456 464, 1996 12) Pseudomonas aeruginosa Jpn. J. Antibiotics 49: 544 554, 1996

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 67( 67 ) 13) 1994 Jpn. J. Antibiotics 49: 849 891, 1996 14) 1995 Jpn. J. Antibiotics 50: 143 177, 1997 15) 1996 Jpn. J. Antibiotics 52: 398 430, 1999 16) Bacteroides fragilis group 28: 48 54, 1998 17) 29: 104 111, 1999 18) 30: 36 43, 2000 19) 30: 141 147, 2000 20) 1997 Jpn. J. Antibiotics 53: 533 565, 2000 21) 1998 Jpn. J. Antibiotics 54: 497 531, 2001 22) 32: 94 102, 2002 23) 1999 Jpn. J. Antibiotics 55: 697 729, 2002 24) 2000 Jpn. J. Antibiotics 55: 730 763, 2002 25) 2001 Jpn. J. Antibiotics 56: 105 137, 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

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

THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 69( 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.