Staphylococcus epidermidis Streptococcus pneumoniae Staphylococcus epidermidis Streptococcus pneumontae S. epidermidis Table 1. Summary of the organis

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Staphylococcus aureus S. aureus (MRSA) vancomycin (VCM), arbekacin (ABK) Streptococcus pneumoniae cefuzonam (CZON), cefpirome (CPR) S. pneumoniae Enterococcus faecalis ampicillin (ABPC), imipenem (IPM) Escherichia coli Klebsiella pneumoniae Haemophilus influenzae ciprofloxacin (CPFX) Pseudomonas aeruginosa Staphylococcus epidermidis Key words: susceptibility, g-lactam, methicillin-resistant S. aureus (MRSA), meca gene, S. epidermidis

Staphylococcus epidermidis Streptococcus pneumoniae Staphylococcus epidermidis Streptococcus pneumontae S. epidermidis Table 1. Summary of the organisms and antibacterial agents used MIC determination performed. ABPC: ampicillin, AMPC: amoxicillin, MPIPC: axacillin, DMPPC: methicillin, PCG: benzylpenicillin, PIPC: piperacillin, CEZ: cefazolin, CTM: cefotiam, CMZ: cefmetazole, CAZ: ceftazidime, CZON: cefuzonam, CPZ: cefoperazone, SBT/CPZ: sulbactum/ cefoperazone, CPR: cefpirome, CFS, cefsulodin, CFX: cefoxitin, LMOX: latamoxef, FMOX: flomoxef, CCL: cefaclor, CETB: ceftibuten, CFDN: cefdinir, IPM: imipenem, MEPM: meropenem, AZT: aztreoram, TOB: tobramycin, AMK: amikacin, ABK: arbekacin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, EM: erythromycin, CLDM: clindamycin, FOM: fosfomycin, TC: tetracycline, MINO: minocycline, CP: chloramphenicol, VCM: vancomycin, ST: sulfamethoxazole-trimethoprim, MTZ: metronidazole

S. epidemidis: S. epidemidis S. aureus: S. aureus S. aureus aureus (MRSA)13) S. pneumoniae: S. pneumoniae E. faecalis: Table 2. Susceptibility distribution of clinical isolates of MSSA (90 isolates) MSSA: methicillin-susceptible Staphylococcus aureus (MPIPC MIC: 3.13 Đg/ml) MPIPC: oxacillin, DMPPC: methicillin, CEZ: cefazolin, CTM: cefotiam, CMZ: cefmetazole, CZON: cefuzonam, FMOX: flomoxef CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, IPM: imipenem, MEPM: meropenam, TOB: tobramycin, ABK: arbekacin, OFLX:, ofloxacin, LFLX: lomefloxacin, EM: erythromycin, TC: tetracycline, MINO: minocycline, VCM: vancomycin, ST: sulfamethoxazole-trimethoprim, FOM: fosfomycin

VOL. 43 NO. 1 Table 3. Susceptibility distribution of clinical isolates of MRSA (125 isolates) MRSA: methicillin-resistant Staphylococcus aureus (MPIPC MIC: 6.2543_0026g/ml) MPIPC: oxacillin, DMPPC: methicillin, CEZ: cefazolin, CTM: cefotiam, CMZ: cefmetazole, CZON: cefuzonam, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, IPM: imipenem, MEPM: meropenam, TOB: tobramycin, ABK: arbekacin, OFLX: ofloxacin, LFLX: lomefloxacin, EM: erythromycin, TC: tetracycline, MINO: minocycline, VCM: vancomycin, ST: sulfamethoxazole-trimethoprim, FOM: fosfomycin Table 4. Susceptibility distribution of clinical isolates of Staphylococcus epidermidis (139 isolates) MPIPC: oxacillin, DMPPC: methicillin, CEZ: cefazolin, CZON: cefuzonam, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, IPM: imipenem, MEPM: meropenam, TOB: tobramycin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, VCM: vancomycin

K. pneumoniae: P. mirabilis: Table 5. Susceptibility distribution of clinical isolates of Streptococcus pneumoniae (51 isolates) AMPC: amoxicillin, PCG: benzylpenicillin, CEZ: cefazolin, CTM: cefotiam, CMZ: cefmetazole, CAZ: ceftazidime, CZON: cefuzonam, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, IPM: imipenem, MEPM: meropenem, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, EM: erythromycin, VCM: vancomycin Table 6. Susceptibility distribution of clinical isolates of Enterococcus faecalis (99 isolates) ABPC: ampicillin, SBT/CPZ: sulbactum/cefoperazone, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, IPM: imipenem, MEPM: meropenem, TOB: tobramycin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, VCM: vancomycin

VOL.43 NO.1 Table 7. Susceptibility distribution of clinical isolates of Escherichia coil (168 isolates) ABPC: ampicillin, AMPC: amoxicillin, CEZ: cefazolin, CTM: cefotiam, CMZ: cefmetazole, SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, CZON: cefuzonam, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, CETB: ceftibuten, IPM: imipenern, MEPM: meropenem, AZT: aztreonam, TOB: tobramycin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, MINO: minocycline, FOM: fosfomycin P. vulgaris: H. influenzae: C. freundii: E. cloacae: M. catarrhalis: S. marcescens: N. gonorrhoeae: P. aeruginosa:

Table 8. Susceptibility distribution of clinical isolates of Klebsiella pneumoniae (90 isolates) ABPC: ampicillin, AMPC: amoxicillin, CEZ: cefazolin, CTM: cefotiam, CMZ: cefmetazole, SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, CETB: ceftibuten, IPM: imipenem, MEPM: meropenem, AZT: aztreonam, TOB: tobramycin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, MINO: minocycline B. fragilis: S. aureus S. epidermidis S. andermidis

VOL.43 NO. 1 Table 9. Susceptibility distribution of clinical isolates of Proteus mirabilis (56 isolates) ABPC: ampicillin, AMPC: amoxicillin, CEZ: cefazolin, CTM: cefotiam, CMZ: cefmetazole, SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, CZON: cefuzonam, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, CETB: ceftibuten, IPM: imipenem, MEPM: meropenem, AZT: aztreonam, TOB: tobramycin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, FOM: fosfomycin Table 10. Susceptibility distribution of clinical isolates of Proteus vulgaris (49 isolates) SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, CZON: cefuzonam, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CFDN: cefdinir, CETB: ceftibuten, 1PM: imipenem, MEPM: meropenem, AZT: aztreonam, TOB: tobramycin, AMK: amikacin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, FOM: fosfomycin

Table 11. Susceptibility distribution of clinical isolates of Citrobacter freundii (58 isolates) SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, CZON: cefuzonam, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, CETB: ceftibuten, IPM: imipenem, MEPM: meropenem, AZT: aztreonam, TOB: tobramycin, AMK: amikacin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, MINO: minocycline, Table 12. Susceptibility distribution of clinical isolates of Enterobacter cloacae (93 isolates) CPZ: cefoperazone, SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, CZON: cefuzonam, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CETB: ceftibuten, IPM: imipenem, MEPM: meropenem, AZT: aztreonam, TOB: tobramycin, AMK: amikacin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, MINO: minocycline

Table 13. Susceptibility distribution of clinical isolates of Serratia marcescens (93 isolates) SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, CZON: cefuzonam, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CETB: ceftibuten, IPM: imipenem, MEPM: meropenem, AZT: aztreonam, AMK: amikacin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, FOM: fosfomycin Table 14. Susceptibility distribution of clinical isolates of Haemophilus influenzae (60 isolates) ABPC: ampicillin, AMPC: amoxicillin, SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, CZON: cefuzonam, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, CETB: ceftibuten, 1PM: imipenem, MEPM: meropenem, AZT: aztreonam, TOB: tobramycin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, EM: erythromycin, MINO: minocycline

Table 15. Susceptibility distribution of clinical isolates of Moraxella (B.) catarrhalis (38 isolates) SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, CZON: cefuzonam, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, CETB: ceftibuten, IPM: imipenem, MEPM: meropenem, TOB: tobramycin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, EM: erythromycin, MINO: minocycline Table 16. Susceptibility distribution of clinical isolates of Neisseria gonorrhoeae (23 isolates) ABPC: ampicillin, AMPC: amoxicillin, SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, CZON: cefuzonam, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CCL: cefaclor, CFDN: cefdinir, CETB: ceftibuten, IPM: imipenem, MEPM: meropenem, AZT: aztreonam, OFLX: ofloxacin, CPFX: ciproxacin, LFLX: lomefloxacin, EM: erythromycin, MINO: minocycline, TC: tetracycline

VOL.43 NO.1 Table 17. Susceptibility distribution of clinical isolates of Pseudomonas aeruginosa (103 isolates) PIPC: piperacillin, SBT/CPZ: sulbactum/cefoperazone, CAZ: ceftazidime, CFS: cefsulodin, LMOX: latamoxef, CPR: cefpirome, IPM: imipenem, MEPM: meropenem, AZT: aztreonam, TOB: tobramycin, AMK: amikacin, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, FOM: fosfomycin Table 18. Susceptibility distribution of clinical isolates of Bacteroides fragilis (48 isolates) PIPC: piperacillin, CFS: cefsulodin, CMZ: cefmetazole, CAZ: ceftazidime, SBT/CPZ: sulbactum/cefoperazone, LMOX: latamoxef, FMOX: flomoxef, CPR: cefpirome, CETB: ceftibuten, IPM: imipenem, MEPM: meropenem, OFLX: ofloxacin, CPFX: ciprofloxacin, LFLX: lomefloxacin, CLPM: clindamycin, CP: chloramphenicol, MTZ: metronidazole S. epidermidis (MRSE) S. pneumoniae S. pneumoniae S. pneumoniae E. coli, K. pneumoniae, P. mirabilis

Table 19. Correlations between the MICs of oxacillin and those of methicillin and flomoxef in Staphylococcus aureus Oxacillin MIC 3.13ƒÊg/ml,2Oxacillin MIC 6.25ƒÊg/ml Table 20. Correlations between the presence of the meca gene in Staphylocoucus us epidermidis and susceptibility to Absence of the mec A gene, 2)Presence of the mec A gene C. freundii E. cloacae E. cloacae E. aerogenes P. aerugznosa S. marcescens B. fragilis S. pneumoniae, E. faecalis S. pneumoniae E. coli, K. pneumoniae E. coli, K. pneumoniae, H. influenzae umoniae, C. freundii, E. cloacae E. faecalis P. aeruginosa B. fragilis P. aeruginosa

VOL.43 NO.1 aureus S. aureus S. aureus 5) Hansman D, Bullen M M: A resistant pneumococcus. Lancet 2:264 `265, 1967 6) Jacobs M R, Koonrnhof H J, Robins-Broune R I, Miller G B, Witcomb M A, Isaacson M, Ward J I, Austrian R: Emergence of multiply resistant pneumococci. N. Engl. J. Med. 299: 735 `740, 1978 7) National Committee for Clinical Laboratory Standards.: Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically, 2 nd ed. M 7-A 2 National Committee for Clinical Laboratory Standards., Villanova, Pa. 1990 8) Payne D J: Metallo-P-lactamases a new therapeutic charange. J. Med. Microbiol. 39: 93 `99, 1993 S. epidermidis S. epidermidis Serratiamarcescens epidermidis 16) Suzuki E, Hiramatsu K, Yokota T: Survey of methycillin-resistant clinical strains of coagulase egative staphylococci for mec A gene distribution. Antimicrob. Agents Chemother. 36:429 `434, 1992

Surveillance of the susceptibility of clinical isolates of various bacterial species to antibacterial agents Shimaru Sasaki, Kaoru Nagano, Yoshiji Kimura, Yutaka Jinushi, Hiroshi Nagata, Kouichi Uotani and Isao Higashiyama Kanzakigawa Laboratories, Shionogi Research Laboratories, Shionogi and Co., Ltd., 3-1-1 Futaba-cho, Toyanaka, Osaka 561, Japan We used agar-dilution MIC determinations to asses the activity of 39 antibacterial agents against various clinical isolates (16 species, 1,386 strains), most of which were isolated in 1992 at 18 facilities in Japan. We found that 58.1% of the strains of Staphylococcus aureus were methicillin-resistant S. aureus (MRSA) Vancomycin (VCM) and arbekacin (ABK) proved to have the highest antibacterial activity against these MRSA with an MIC90 of 0.78 and 1.56 ƒêg/ ml, respectively. Most of the fl-lactam antibiotics displayed high antibacterial activity against Streptococcus pneumoniae, especially cefuzonam (CZON), cefpirome (CPR) and the carbapenems, whose MICH was less than 0.39ƒÊg/ml. The incidence of penicillin-resistant S. pneumoniae was 37.0%. The agents which showed the highest antibacterial activity against Enterococcus faecalis were ampicillin (ABPC), imipenem (IPM) and VCM (MICK) 3.13,ig/ml). Most cephems, carbapenems and quinolones exhibited high antibacterial activity against Escherichia coli and Klebsiella pneumoniae with an MIC90 of less than 3.13ƒÊg/ml. Most cephems, carbapenems and quinolones also showed high antibacterial activity against Haemophilus influenzae, with that of ciprofloxacin (CPFX) being especially high with MICK, of 0.013 pg/ml. ABPC-resistant H. influenzae accounted for 10.0% of the H. influenzae strains. Carbapenems displayed the highest antibacterial activity against Pseudomonas aeruginosa (MIC90 6.25 ƒêg/ml). Ceftazidime (CAZ) -resistant P. aeruginosa strains and IPM-resistant P. aeruginosa strains accounted for 29.1% and 8.7% of their groups, respectively, while quinolone-resistant strains represented 16.5-33.0%. Suitable antibiotics for detecting MRSA by agar-dilution MIC determination were oxacillin (MPIPC) and flomoxef (FMOX). meca-positive strains accounted for 73.4% of Staphylococcus epidermidis strains and the presence of the meca gene coincided with MPIPC susceptibility.

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