Oct THE JAPANESE JOURNAL OF ANTIBIOTICS Pseudomonas aeruginosa 186 P. aeruginosa piperacillin PIPC, taz

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Transcription:

Oct. 2016 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 327 27 2013 2014 2016 7 5 2013 2014 Pseudomonas aeruginosa 186 P. aeruginosa piperacillin PIPC, tazobactam/piperacillin TAZ/PIPC, ceftazidime CAZ, cefepime CFPM, imipenem IPM, meropenem MEPM, doripenem DRPM, aztreonam AZT, ciprofloxacin CPFX, levofloxacin LVFX, amikacin AMK colistin CL MIC 50/90 8/32, 4/32, 2/8, 2/16, 1/32, 0.5/8, 0.25/4, 8/32, 0.25/8, 0.5/16, 4/8 1/1 μg/ml2 1.1%

328 28 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 Oct. 2016 P. aeruginosa Pseudomonas aeruginosa 1 3 MDRP 4 MDRP 5,6 7 8 10 2013 2014 I. 1. 2013 10 2014 2 186 5 2. Piperacillin PIPC, tazobactam/piperacillin TAZ/PIPC, ceftazidime CAZ, cefepime CFPM, imipenem/cilastatin IPM/CS, meropenem MEPM, doripenem DRPM, aztreonam AZT, ciprofloxacin

Oct. 2016 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 329 29 CPFX, levofloxacin LVFX, amikacin AMK, colistin CL 12 IPM/ CS IPM TAZ/PIPC TAZ 4 μg/ml PIPC MIC 3. MIC Clinical and Laboratory Standards Institute CLSI 11 CLSI MIC interpretive standard 12 4. SAS release 9.2 χ II. 1. 2013 2014 186 43 25 18 20 2823 524 19 24 23 5 80 43.0% 79 42.5%27 14.5% 2. 2 1. 186 MIC 50, MIC 90 1 12 β- DRPM MIC 50 0.25 μg/ml MEPM 0.5 μg/ml, IPM 1 μg/ml, CAZ CFPM 2 μg/ml, TAZ/PIPC 4 μg/ml, PIPC AZT 8 μg/ml MIC 90 DRPM 4 μg/ml CAZ, MEPM 8 μg/ ml, CFPM 16 μg/ml, PIPC, TAZ/PIPC, IPM, AZT 32 μg/ml CAZ 90.3% CFPM 88.2%, TAZ/ PIPC 85.5%, PIPC 85.0%, DRPM 84.4%, MEPM 78.5%, IPM 73.7%, AZT 73.1% CPFX LVFX MIC 50 0.25 μg/ml, 0.5 μg/mlmic 90 8 μg/ml 16 μg/ml 85.0%, 79.6% AMK MIC 50 MIC 90 4 μg/ml, 8 μg/ml 97.8% CL MIC 50 MIC 90 1 μg/ml 2 2. 186 IPM 4 μg/ml MIC 49 MIC 50, MIC 90 2 186 1 CL MEPM DRPM 22.4% 40.8% 50% P 0.0001 AMK 91.8%6% P 0.0389 CPFX LVFX 61.2% 53.1% P 0.0002

330 30 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 Oct. 2016 1. 2013 2014 186 MIC 50, MIC 90

Oct. 2016 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 331 31 2. 2013 2014 186 IPM 4 μg/ml 49 MIC 50, MIC 90

332 32 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 Oct. 2016 PIPC TAZ/PIPC 63.3% 65.3% P 0.0007 0.0013 CAZ CFPM 75.5% 67.3% P 0.0057 0.0004 AZT 53.1% P 0.0070 20% 2 3. MDRP CPFX MIC 4 μg/ml IPM MIC 16 μg/ml AMK MIC 32 μg/ml www.mhlw.go.jp/bunya/kenkou/ kekkaku-kansenshou11/01-05-42-01.html 2008 5 9 334 13 3 CPFX, IPM, AMK 186 24 12.9% 35 18.8% 4 2.2% IPM, CPFX, AMK CPFX IPM, CPFX AMK, IPM AMK 2 15 8.1% 3 1.6% 3 1.6% CPFX IPM 2 3 MDRP 2 1.1% 2008 CPFX, IPM AMK 2 MDRP 2008 1.1% P 0.1275 2 4. Susceptible Intermediate Resistant 2008 5 9 334 13 1 PIPC, TAZ/PIPC, CAZ, CFPM, IPM, MEPM, DRPM, AZT AMK 2008 CPFX 76.0% 85.0% P 0.0165 LVFX 73.4% 79.6% P 0.1137 CL 96.4% 100.0% P 0.0055 3. 3.

Oct. 2016 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 333 33 1. MIC 50, MIC 90 4, 5, 6 2 β- TAZ/PIPC 92.6% 87.5% 81.0% CAZ 96.3%, 92.5%, 86.1% IPM 80.0% 73.4% 55.6% MEPM 85.0%, 74.7%, 70.4% LVFX 92.6% 80.0% 74.7% CL, AMK 4. MIC 50 MIC 90 7 AMK CL MIC 50, MIC 90 CFPM, MEPM, DRPM, AZT CPFX MIC 50 4 8MIC 90 PIPC, AMK, CL 8 512 III. 13 17 2013 2014 10 186 β- PIPC, TAZ/PIPC, CAZ, CFPM, IPM, MEPM, DRPM AZT MIC 50/90 8/32, 4/32, 2/8, 2/16, 1/32, 0.5/8, 0.25/4,

334 34 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 Oct. 2016 4. 80 MIC 50, MIC 90

Oct. 2016 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 335 35 5. 79 MIC 50, MIC 90

336 36 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 Oct. 2016 6. 27 MIC 50, MIC 90

Oct. 2016 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 337 37 2. 8/32 μg/ml DRPM MIC 50/90 CLSI CAZ, CFPM, TAZ/PIPC 2008 334 13 PIPC, TAZ/PIPC, CAZ, CFPM, IPM, MEPM, DRPM AZT MIC 50/90 8/32, 8/32, 2/8, 4/16, 2/16, 0.5/8, 0.5/4 8/32 μg/ml 2010 303 18 PIPC, TAZ/PIPC, CAZ, CFPM, IPM, MEPM MIC 50/90 8/128, 8/64, 2/32, 4/16, 2/16, 0.5/16 μg/ml TAZ/PIPC 85.5% 80.9% MEPM 78.5% 72.9% 5% IPM 4 μg/ml MIC 49 CL AMK 6% 20 50% MDRP CL 2008 CL CL MIC 50 MIC 90 1 μg/mlclsi 100% AMK CPFX, IPM MDRP 2008 13 2 MDRP

338 38 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 Oct. 2016 7.

Oct. 2016 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 339 39 CAZ, TAZ/PIPC 96.3%, 92.6% IPM, MEPM 55.6%, 70.4% 19 3 1 8 7 β- 7 MEPM DRPM MIC 90 8 64 500 5 1 2013 2014 186 2008 MSD MSD MSD Meiji Seika MSD Meiji Seika

340 40 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 Oct. 2016 1 37: 33 41, 2014 2 GÓMEZ, M. I. & A. PRINCE: Opportunistic infections in lung disease: Pseudomonas infections in cystic fibrosis. Curr. Opin. Pharmacol. 7: 244 251, 2007 3 OSIH, R. B.; J. C. MCGREGOR, S. E. RICH, et al.: Impact of empiric antibiotic therapy on outcomes in patients with Pseudomonas aeruginosa bacteremia. Antimicrob. Agents Chemother. 51: 839 844, 2007 4 TSUJI, A.; I. KOBAYASHI, T. OGURI, et al.: An epidemiological study of the susceptibility and frequency of multiple-drug-resistant strains of Pseudomonas aeruginosa isolated at medical institutes nationwide in Japan. J. Infect. Chemother. 11: 64 70, 2005 5 SEKIGUCHI, J.; T. ASAGI, T. MIYOSHI-AKIYAMA, et al.: Multidrug-resistant Pseudomonas aeruginosa strain that caused an outbreak in a neurosurgery ward and its aac 6 -Iae gene cassette encoding a novel aminoglycoside acetyltransferase. Antimicrob. Agents Chemother. 49: 3734 3742, 2005 6 KIRIKAE, T.; Y. MIZUGUCHI & Y. ARAKAWA: Investigation of isolation rates of Pseudomonas aeruginosa with and without multidrug resistance in medical facilities and clinical laboratories in Japan. J. Antimicrob. Chemother. 61: 612 615, 2008 7 Jpn. J. Antibiotics 58: 458 468, 2005 8 2004 2005 55: 278 285, 2007 9 2007 72 12,919 Jpn. J. Antibiotics 62: 346 366, 2009 10 2004 Jpn. J. Antibiotics 59: 355 363, 2006 11 CLSI: Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; Approved standard-ninth edition. M07-A9. CLSI 32: 2012 12 CLSI: Performance standards for antimicrobial susceptibility testing; twenty-third informational supplement. M100-S23. CLSI 33: 2013 13 2008 Jpn. J. Antibiotics 65: 15 26, 2012 14 Haemophilus influenzae 2009 2010 Jpn. J. Antibiotics 65: 305 321, 2012 15 2008 2009 Jpn. J. Antibiotics 65: 1 14, 2012 16 β- Jpn. J. Antibiotics 66: 251 264, 2013 17 2010 2011 Jpn. J. Antibiotics 66: 265 282, 2013 18 tazobactam/piperacillin 61: 514 525, 2013 19 52: 17 22, 2004

Oct. 2016 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 5 341 41 Sensitivity surveillance of Pseudomonas aeruginosa isolates for several antibacterial agents in Chubu area 2013 2014 Chubu Anti-biogram Study Group Research Laboratories, Toyama Chemical Co., Ltd., Development Division, Toyama Chemical Co., Ltd. AI KAKUMOTO, HAYATO OKADE, SHINGO MIZUNAGA and NOBUHIKO NOMURA Research Laboratories, Toyama Chemical Co., Ltd. JUNICHI MITSUYAMA Development Division, Toyama Chemical Co., Ltd. KAZUKIYO YAMAOKA Gifu University of Medical Science YUKO ASANO Department of Clinical Laboratory Medicine, Ogaki Municipal Hospital YOKO MATSUKAWA Clinical Laboratories, Gifu Prefectural Tajimi Hospital HIROYUKI SUEMATSU and HARUKI SAWAMURA Department of Infection Control and Prevention, Aichi Medical University Hospital SHIGENORI MATSUBARA Matsubara Otorhinolaryngology Clinic NAOHIRO SHIBATA Department of Infectious Diseases, Tohno Kousei Hospital KUNITOMO WATANABE Division of Anaerobe Research, Life Science Research Center, Gifu University YOSHIHIRO YAMAMOTO Department of Clinical Infectious Diseases, Toyama University Hospital HIROMICHI IWASAKI Division of Infection Control and Prevention, University of Fukui Hospital YUKA YAMAGISHI and HIROSHIGE MIKAMO Department of Clinical Infectious Diseases, Aichi Medical University We investigated the susceptibility to antibacterial agents of 186 clinical isolates of Pseudomonas aeruginosa isolated from medical facilities in Gifu, Aichi, Toyama, and Fukui prefectures from October 2013 to February 2014. MIC 50/90 of piperacillin PIPC, tazobactam/piperacillin TAZ/PIPC, ceftazidime CAZ, cefepime CFPM, imipenem IPM, meropenem MEPM, doripenem DRPM, aztreonam AZT, ciprofloxacin CPFX, levofloxacin LVFX, amikacin AMK and colistin CL against P. aeruginosa was 8/32, 4/32, 2/8, 2/16, 1/32, 0.5/8, 0.25/4, 8/32, 0.25/8, 0.5/16, 4/8 and 1/1 μg/ml respectively. Two strains of multidrug resistant P. aeruginosa were isolated 1.1% They were isolated from the respiratory tract, intra-abdominal, and urinary infection. The susceptible ratio against P. aeruginosa derived from intra-abdominal infection for carbapenem was lower than those from respiratory tract and urinary infection. The susceptible ratio against P. aeruginosa derived from urinary infection for penicillin, cephem, monobactam, and fluoroquinolone was lower than those from respiratory and intra-abdominal infection. It is meaningful to pay attention to the susceptibility to antibacterial agents in each clinical specimen from infected organ.

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