美罗培南对临床分离致病菌的体外抗菌活性研究

目的评价美罗培南的体外抗菌活性方法采用琼脂二倍稀释法测定美罗培南及对照药亚胺培南、头孢吡肟、头孢他啶、头孢哌酮／舒巴坦、环内沙星对412株临床分离致病菌的体外抗菌活性。结果显示，对多种革兰氏阴性菌，美罗培南均有较强的抗菌作用，其抗菌作用强于对照药亚胺培南、头孢吡肟、头孢他啶、环丙沙星、奈替米星；对大肠埃希氏菌、克雷泊氏菌属、产气肠杆菌、志贺氏菌属、沙门氏菌属、柠檬酸菌属、变形菌属、沙雷氏菌属MIC90≤0．008～0．25mg/L，是亚胺培南MIC9o的1／4～1／16，对阴沟肠杆菌、不动杆菌属与亚胺培南的抗菌作用相当，分别为0．25、0．5mg／L：对流感嗜血杆菌美罗培南的MIC90为0．125mg／L，是亚胺培南的1／16，是第四代头孢菌素头孢吡肟的1/4：对铜绿假单孢菌美罗培南的MIC90为4mg／L，低于亚胺培南8mg／L。对革兰氏阳性菌作用稍差于亚胺培南，优予其他4种对照药。     

鲍曼不动杆菌对米诺环素等抗菌药物的耐药性研究

目的 初步探讨米诺环素等16种临床常用抗菌药物对鲍曼不动杆菌的体外抗菌活性,为临床合理用药提供实验依据.方法 四川大学华西医院抗感染药物研究室分离自临床感染患者的115株非重复多重耐药鲍曼不动杆菌菌株,采用琼脂二倍稀释法进行16种临床常用抗菌药物体外抗菌活性测定.结果 米诺环素和多黏菌素B对鲍曼不动杆菌有很好的抗菌活性,MIC50分别为4μg/mL与0.25μg/mL,MIC90分别为16μg/mL与4μg/mL,亚胺培南等碳青霉烯类抗生素对多重耐药的鲍曼不动杆菌也有较强的抗菌活性,MIC50为2μg/mL,MIC90为32μg/mL.结论 米诺环素、多黏菌素B、亚胺培南对临床分离鲍曼不动杆菌具有良好的抗菌活性,可作为治疗选择药物.     

比阿培南与其他抗菌药物对某院临床分离致病菌的体外敏感性比较

目的:比较研究比阿培南和其他抗菌药物的体外抗菌活性。方法:收集2015年1-5月某院分离的344株临床常见致病菌,采用纸片扩散法测定比阿培南和对照药(美罗培南、亚胺培南、厄他培南、氨曲南、左氧氟沙星、哌拉西林他唑巴坦、头孢他啶和头孢吡肟)对革兰阴性菌的敏感性,及比阿培南和对照药(美罗培南、左氧氟沙星、万古霉素、利奈唑胺、克林霉素、青霉素和呋喃妥因)对革兰阳性菌的敏感性。结果:比阿培南与美罗培南、亚胺培南、厄他培南、哌拉西林他唑巴坦对产和不产ESBL的大肠埃希菌和肺炎克雷伯菌、阴沟肠杆菌及其他肠杆菌的敏感率相仿,且差异无统计学意义(P>0.05),但比阿培南对铜绿假单胞菌的敏感率显著高于其他抗菌药物(P<0.05);比阿培南与美罗培南对甲氧西林敏感的金葡菌、耐甲氧西林的金葡菌、粪肠球菌和屎肠球菌的敏感率相仿,但显著低于万古霉素、利奈唑胺和呋喃妥因(P<0.001)。结论:与其他抗菌药物相比,比阿培南对某院临床分离的革兰阴性菌尤其是铜绿假单胞菌有较高的敏感率,但对鲍曼不动杆菌和肠球菌有较高的耐药率。     

帕尼培南-倍他米隆体外抗菌活性及其对肺部感染病人的疗效观察

目的 :了解帕尼培南 倍他米隆对临床常见致病菌的体外抗菌活性及治疗肺部感染的有效性及安全性。方法 :采用琼脂二倍稀释法测定帕尼培南 倍他米隆对 2 4 7株临床分离菌的MIC ,检测其对部分菌株的最低杀菌浓度 ;2 0例肺部感染病人使用帕尼培南 倍他米隆 5 0 0 /5 0 0mg ,q 12h ,iv ,gtt ,疗程3～ 7d。结果 :帕尼培南 倍他米隆与帕尼培南的体外抗菌活性基本一致 ,MIC50 ≤ 0 .0 0 75mg·L- 1,MIC90 为 0 .0 0 75～ 2mg·L- 1;对流感嗜血杆菌的MIC范围为 <0 .0 0 75～ 0 .12 5mg·L- 1;对阴沟肠杆菌、变形肠杆菌、铜绿假单孢菌的MIC50 和MIC90 分别为 0 .12 5和 0 .5 ,2和 4 ,4和 16mg·L- 1;帕尼培南 倍他米隆对金黄色葡萄球菌、表皮葡萄球菌、铜绿假单孢菌、肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌、变形肠杆菌及微球菌的最低杀菌浓度分别是其MIC的 1～ 8倍。致病菌阴转率为 77.8% ,治疗有效率为 75 % ,未出现明显不良反应。结论 :帕尼培南 倍他米隆对临床常见致病菌的体外抗菌活性强 ;对肺部感染有较好疗效 ,安全性好     

比阿培南与亚胺培南的体外抗菌活性对比分析

目的:观察比阿培南与亚胺培南对292株临床常见革兰阴性菌的体外抗菌活性,为临床合理用药提供依据。方法:收集292株临床分离常见菌,采用k-B纸片扩散法检测比阿培南与亚胺培南的药物敏感性,采用梅里埃公司的VITEK2 COMPACT全自动微生物分析仪进行菌种鉴定。结果:比阿培南与亚胺培南对大肠埃希菌、阴沟肠杆菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌的敏感率分别为100%、100%、98.11%、84.29%、39.24%和100%、100%、98.11%、71.43%、36.71%。结论:比阿培南与亚胺培南的体外抗菌活性相似,对临床常见革兰阴性菌具有广谱杀菌活性。     

碳青霉烯类抗菌药物对肠杆菌科细菌及非发酵菌的防突变浓度研究

目的评价碳青霉烯类抗菌药物对临床分离的100株大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌的防突变浓度(MPC)。方法采用琼脂稀释法测定碳青霉烯类抗菌药物(亚胺培南、美洛培南、厄他培南和多利培南)对临床分离的肠杆菌科和非发酵菌菌株的最小抑菌浓度(MIC)及MPC,并计算MPC/MIC比值。结果碳青霉烯类抗菌药物对肠杆菌科敏感株的MPC为0.25~4.0μg·m L~(-1),耐药株MPC为8.0~>64.0μg·m L~(-1)。多利培南、亚胺培南、美洛培南对非发酵菌敏感株的MPC为2.0~4.0μg·m L~(-1),耐药株MPC为8.0~128μg·m L~(-1)。肠杆菌科细菌和非发酵菌敏感株的MPC/MIC比值为2~4,耐药株多为8~>16。结论碳青霉烯类抗菌药物对肠杆菌科和非发酵菌敏感株的MPC为0.125~4.0μg·m L~(-1),MPC/MIC比值为2~4;对耐药株的MPC为2.0~128.0μg·m L~(-1),MPC/MIC比值为8~>16。     

重症监护患者肠杆菌科细菌感染比阿培南给药方案的优化

目的:优化医院重症监护患者肠杆菌科细菌感染比阿培南的治疗方案。方法:收集某院5种294株常见肠杆菌科致病菌,采用2倍琼脂稀释法测定比阿培南的最低抑菌浓度(MIC),运用蒙特卡洛模拟(MCS)比阿培南4种给药方案(0.3g q12h;0.3g/q8h;0.3g/q6h;0.6g/q12h)传统短时滴注(0.5h)和延时滴注(1~4h),计算达标概率(PTA)和累积反应分数(CFR)。结果:对大肠埃希菌,所有方案的CFR均>90%;对肺炎克雷伯菌,比阿培南0.3g/q12h静滴<3h,0.6g/q12h静滴<2h方案的CFR<90%;对阴沟肠杆菌,比阿培南0.3g/q12h静滴<2h的CFR<90%;对粘质沙雷菌,所有方案的CFR均<90%;对产气肠杆菌,比阿培南0.3g/q12h传统短时滴注方案CFR<90%。当MIC≥2μg·mL^-1时,所有方案PTA均<90%。结论:ICU患者肠杆菌科细菌感染的经验治疗,建议比阿培南0.3g/q8h、q6h或0.3g/q12h滴注3h以上的给药方案,针对粘质沙雷菌感染建议联合或换用其他抗菌药物。目标治疗则应根据致病菌MIC值选用相应的给药方案。在MIC≥2μg·mL^-1时建议根据药敏结果联合或换用其他抗菌药物。     

国产替比培南体外抗菌活性

目的评价国产替比培南对我国2009―2011年临床分离致病菌的体外抗菌作用及影响因素。方法2009―2011年全国17个城市19家医院临床分离致病菌557株,包括革兰阳性菌213株,革兰阴性菌307株,厌氧菌37株。采用标准琼脂二倍稀释法测定替比培南及对照药的最低抑菌浓度(MIC),并对其中52株菌进行了不同细菌接种量(1×105、1×106、1×107、1×108 CFU·m L-1)和培养基不同p H值(p H5.0、p H6.0、p H7.0、p H8.0、p H9.0)、不同马血清含量(0%、25%、50%、75%)条件下的替比培南MIC测定。结果替比培南对甲氧西林敏感葡萄球菌、链球菌、肠杆菌科细菌、嗜血杆菌、卡他莫拉菌以及厌氧菌均具有良好抗菌作用,其体外抗菌活性优于亚胺培南2⁸倍,优于法罗培南48倍,优于法罗培南4¹6倍。特别对于青霉素敏感肺炎链球菌和化脓性链球菌,替比培南的MIC值低于0.002 mg·L-1,显示了很强的抗菌作用。各影响因素测定结果表明,细菌接种量、培养基p H值6.016倍。特别对于青霉素敏感肺炎链球菌和化脓性链球菌,替比培南的MIC值低于0.002 mg·L-1,显示了很强的抗菌作用。各影响因素测定结果表明,细菌接种量、培养基p H值6.0⁹.0以及马血清含量在25%以内对替比培南MIC值基本无影响。当培养基p H值为5.0时,可使金黄色葡萄球菌的MIC值明显下降;培养基中加入50%或更多马血清,可使替比培南对所测多数菌的MIC上升29.0以及马血清含量在25%以内对替比培南MIC值基本无影响。当培养基p H值为5.0时,可使金黄色葡萄球菌的MIC值明显下降;培养基中加入50%或更多马血清,可使替比培南对所测多数菌的MIC上升2¹6倍。结论国产替比培南对我国2009―2010年临床分离革兰阳性及阴性致病菌均具有很强的抗菌作用,值得进一步研究。     

比阿培南对医院常见感染菌的抗菌活性分析

目的：调查新药比阿培南对我院,临床分离的常见致病菌的抗菌活性,为临床用药提供依据。方法：收集我院临床分离的135株共7类常见致病菌,采用K—B纸片琼脂扩散法,并设对照组：美罗培南组和亚胺培南组,结果判定参照NCCLS 2006年标准。结果：135株致病菌对比阿培南的药物敏感率为86．6％,对照组：美罗培南为49．6％、亚胺培南为46．2％。比阿培南对铜绿假单胞菌和不动杆菌属的敏感率分别为85％和50％,而美罗培南为50％和20．8％,亚胺培南为40％和8．3％。结论：新药比阿培南的抗菌活性明显高于同类碳青霉烯类抗生素美罗培南和亚胺培南,尤其在对铜绿假单胞菌和不动杆菌属细菌的敏感度上,新药比阿培南更具抗菌活性。     

替比培南匹伏脂的体外抗菌作用研究

目的 评价替比培南匹伏脂的体外抗菌作用.方法 用琼脂对倍稀释法测定替比培南匹伏脂对519株临床分离菌的体外抗菌活性.结果 对革兰阳性球菌中的肺炎链球菌、化脓性链球菌及对甲氧西林敏感的金葡菌和凝固酶阴性的葡萄球菌,替比培南匹伏脂均显示良好的抗菌活性.尤其是对青霉素不敏感肺炎链球菌,替比培南匹伏脂的MIC50最低,为0.25 mg·L-1.本品对流感嗜血杆菌、卡他莫拉菌、产ESBLs和不产ESBLs的肺炎克雷伯菌和大肠埃希菌、易产诱导酶的阴沟肠杆菌、产气肠杆菌、枸橼酸杆菌、粘质沙雷菌的MIC50为≤0.03～5.00 mg· L-1,低于其他5种抗菌药物.结论 替比培南匹伏脂对社区感染中常见病原菌有较好的抗菌活性.     

Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2000). I. Susceptibility distribution

The bacterial strains isolated from patients diagnosed as having urinary tract infections (UTIs) in 10 institutions in Japan were supplied between the period of August 2000 and July 2001. Then, the susceptibilities of them to many kinds of antimicrobial agents were investigated. The number of them were 511 strains. The breakdown of these strains was Gram-positive bacteria as 29.0% and Gram-negative bacteria as 71.0%. Susceptibilities of these bacteria to antimicrobial agents were as follows; vancomycin (VCM), ampicillin (ABPC) and imipenem (IPM) showed strong activities against Enterococcus faecalis. No increase in low-susceptible strains of E. faecalis observed against these antimicrobial agents. VCM showed a strong activity against MRSA preventing growth of all strains with 1 microgram/ml. In addition, the activity of arbekacin (ABK) was strong with the MIC90 of 2 micrograms/ml against MRSA and prevented growth of all strains with 4 micrograms/ml. ABK showed a strong activity against Staphylococcus epidermidis preventing growth of all strains with 0.5 microgram/ml. ABPC, cefotiam (CTM) and cefozopran (CZOP) also showed a relatively strong activity against S. epidermidis (MIC90: 4 to 8 micrograms/ml). Against Escherichia coli, carbapenems showed high activities: meropenem (MEPM) prevented growth of all strains within 0.125 microgram/ml; IPM prevented growth of all strains with 0.25 microgram/ml. CZOP and CTM also showed strong activities against E. coli: MIC90 of CZOP was within 0.125 microgram/ml; MIC80 and MIC90 of CTM were 0.25 and 0.5 microgram/ml, respectively. Quinolone resistant E. coli was detected at frequency of 14.0%, which was significantly higher than that in the last year. Almost all drugs showed strong activities against Klebsiella pneumoniae and Proteus mirabilis, and MEPM prevented growth of all strains within 0.125 microgram/ml. Against Pseudomonas aeruginosa, almost drugs were not so active. The MIC90 of carbapenems and gentamicin (GM) were 16 micrograms/ml and those of all other drugs were more than 32 micrograms/ml. Against Serratia marcescens, the MIC90 of IPM and GM were the lowest value being 2 micrograms/ml, and that of MEPM was 4 micrograms/ml.     

Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2001). I. Susceptibility distribution

The bacterial strains isolated from patients diagnosed as having urinary tract infections (UTIs) in 10 institutions in Japan were supplied between the period of September and December 2001. Then, the susceptibilities of them to a variety of antimicrobial agents were investigated. The number of them were 496 strains. The breakdown of these strains was Gram-positive bacteria as 29.6% and Gram-negative bacteria as 70.4%. Susceptibilities of these bacteria to antimicrobial agents were as follows; against Staphylococcus aureus, vancomycin (VCM) showed a strong activity, and this drug also had a strong activity against MRSA in preventing growth of all strains at 1 microgram/mL. In addition, arbekacin (ABK) showed strong activity with the MIC90 of 2 micrograms/mL against MRSA and prevented growth of all strains at 4 micrograms/mL. ABK also showed a strong activity against Staphylococcus epidermidis in preventing growth of all strains at 0.5 microgram/mL. Ampicillin (ABPC) and cefozopran (CZOP) showed a relatively strong activity against S. epidermidis (MIC90: 8 micrograms/mL). ABPC, imipenem (IPM), and VCM showed strong activities against Enterococcus faecalis. No increase of low-susceptible strains in E. faecalis was observed against these antimicrobial agents. Against Escherichia coli, carbapenems showed the highest activities: meropenem (MEPM) prevented growth of all strains at 0.25 microgram/mL; IPM prevented growth of all strains at 0.5 microgram/mL. CZOP and cefotiam (CTM) also showed strong activities against E. coli: MIC90 of CZOP was within 0.125 microgram/mL; MIC90 of CTM was within 0.5 microgram/mL. Quinolone-resistant E. coli was detected at frequency of 9.3%, which was lower than that in the last year, and was higher level than those in up to 1999. MEPM showed the strongest activity against Citrobacter freundii in preventing growth of all strains at 0.125 microgram/mL. Almost all drugs showed strong activities against Klebsiella pneumoniae and Proteus mirabilis, and MEPM prevented growth of all strains within 0.125 microgram/mL. Against Serratia marcescens, the MIC90 of gentamicin (GM) was the lowest value being 2 micrograms/mL, and those of IPM and carumonam were 8 and 16 micrograms/mL, respectively. Against Pseudomonas aeruginosa, almost all drugs were not so active. The MIC90 of GM was 8 micrograms/mL, those of IPM and amikacin were 16 micrograms/mL, and those of all other drugs were over than 32 micrograms/mL.     

Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1997). I. Susceptibility distribution

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 560 bacterial strains isolated from patients with urinary tract infections (UTIs) in 9 hospitals during the period of June 1997 to May 1998. Of the above bacterial isolates, Gram-positive bacteria accounted for 29.3% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 70.7% and most of them were Escherichia coli. Susceptibilities of several isolated bacteria to antimicrobial agents were as followed; 1. Enterococcus faecalis Ampicillin (ABPC) showed the highest activity against E. faecalis isolated from patients with UTIs. Its MIC90 was 1 microgram/ml. Imipenem (IPM) and vancomycin (VCM) were also active with the MIC90s of 2 micrograms/ml. The others had low activities with the MIC90s of 16 micrograms/ml or above. 2. Staphylococcus aureus including MRSA VCM and arbekacin (ABK) showed the highest activities against both S. aureus and MRSA isolated from patients with UTIs. The MIC90s of them were 1 microgram/ml. The others except minocycline (MINO) had low activities with the MIC90s of 32 micrograms/ml or above. More than a half of S. aureus strains (including MRSA) showed high susceptibilities to gentamicin (GM) and MINO, the MIC50s of 0.25 microgram/ml or 0.5 microgram/ml. 3. Enterobacter cloacae IPM showed the highest activity against E. cloacae. The MICs for all strains were equal to or lower than 1 microgram/ml. The MIC90s of ciprofloxacin (CPFX) and tosufloxacin (TFLX) were 1 microgram/ml, the MIC90s of amikacin (AMK) and ofloxacin (OFLX) were 4 micrograms/ml, the MIC90 of GM was 16 micrograms/ml. Among E. cloacae strains, those with low susceptibilities to quinolones have decreased in 1997, compared with those in 1996. But the other drugs were not so active in 1997 as 1996. 4. Escherichia coli All drugs except penicillins were active against E. coli with the MIC90s of 8 micrograms/ml or below. Particularly, flomoxef (FMOX), cefmenoxime (CMX), cefpirome (CPR), cefozopran (CZOP), IPM, CPFX and TFLX showed the highest activities against E. coli with the MIC90s of 0.125 microgram/ml or below. 5. Klebsiella pneumoniae K. pneumoniae was susceptible to almost all the drugs except penicillins. Carumonam (CRMN) had the strongest activity with the MICs for all strains equal to or lower than 0.125 microgram/ml. FMOX, CPR, CZOP, CPFX and TFLX were also active with the MIC90s of 0.125 microgram/ml or below. The MIC90s of quinolones had changed into a better state in 1997, compared with those in 1996. 6. Proteus mirabilis Almost all the drugs except ABPC and MINO showed high activities against P. mirabilis. CMX, ceftazidime (CAZ), latamoxef (LMOX), CPR, cefixime (CFIX), cefpodoxime (CPDX) and CRMN showed the highest activities against P. mirabilis. The MICs of them for all strains were equal to or lower than 0.125 microgram/ml. CPFX and TFLX were also active with the MIC90s of 0.125 microgram/ml or below. 7. Pseudomonas aeruginosa The MIC90 of GM was 8 micrograms/ml, the MIC90s of AMK, IPM and meropenem (MEPM) were 16 micrograms/ml. The others were not so active against P. aeruginosa with the MIC90s of 32 micrograms/ml or above. The MIC90s of quinolones had changed into a lower state in 1997, compared with those in 1996. 8. Serratia marcescens IPM showed the highest activity against S. marcescens. Its MIC90 was 2 micrograms/ml. GM was also active with the MIC90 of 4 micrograms/ml. The MIC90s of the others were 16 micrograms/ml or above. The MIC50s of CRMN was 0.125 microgram/ml or below, the MIC50s of CPR and CZOP were 0.25 microgram/ml.     

国产环丙氟哌酸的体外抗菌活性研究

本文测定了国产环丙氟哌酸对临床分离的883株需氧菌与58株厌氧菌的抗菌作用。金葡球菌的 MIC_(90) 为1mg/L,除沙雷菌的 MIC_(90)为0.25mg/L外,其他肠杆菌科细菌的 MIC_(90)≤0.06mg/L,绿脓杆菌和不动杆菌属的 MIC_(90)分别为1mg/L和0.125～0.5mg/L,90％以上的耐Ceftazidime和庆大霉素的革兰氏阴性菌对环丙氟哌酸仍敏感。对淋球菌的MIC_(90)≤0.0075mg/L,环丙氟哌酸与氧哌嗪青霉素联合对绿脓杆菌和肠球菌、环丙氟哌酸与庆大霉素联合对耐甲氧西林金葡球菌50％呈协同和相加作用,均未出现拮抗现象。     

Multicentre study of the in vitro evaluation of moxifloxacin and other quinolones against community acquired respiratory pathogens.

The in vitro activity of moxifloxacin was compared with that of ciprofloxacin, levofloxacin, ofloxacin and trovafloxacin against 710 strains (180 Streptococcus pneumoniae, 180 Haemophilus influenzae, 160 Moraxella catarrhalis and 190 Streptococcus pyogenes) isolated from patients with community-acquired respiratory tract infections. MIC values for moxifloxacin, trovafloxacin were 0.25/0.25, 0.03/0.03, 0.06/0.03 and 0.125/0.0125 mg/l for S. pneumoniae, H. influenzae, M. catharralis and S. pyogenes. Based upon the MIC(90) values and the MIC distributions, moxifloxacin and trovafloxacin were the most active of the quinolones tested. They showed enhanced activity against Gram-positive organisms including penicillin non susceptible S. pneumoniae strains. Moxifloxacin was also highly active against ciprofloxacin-resistant S. pneumoniae strains.     

Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (2000)

From October 2000 to September 2001, we collected the specimen from 410 patients with lower respiratory tract infections in 16 institutions in Japan, and investigated the susceptibilities of isolated bacteria to various anti-bacterial agents and antibiotics and patients' characteristics. Of 499 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in inflammation, 493 strains were investigated. The breakdown of the isolated bacteria were: Staphylococcus aureus 78, Streptococcus pneumoniae 73, Haemophilus infiuenzae 99, Pseudomonas aeruginosa (non-mucoid) 64, P. aeruginosa (mucoid) 14, Klebsiella pneumoniae 25, Moraxella subgenus Branhamella catarrhalis 21, etc. Of 78 S. aureus strains, those with 4 micrograms/ml or more of MIC of oxacillin (methicillin-resistant S. aureus: MRSA) occupied 53.8%. Vancomycin and arbekacin had the most potent activities against MRSA as observed in 1999. The frequency of S. pneumoniae exhibiting low sensitivity to penicillin (penicillin-intermediate S. pneumoniae: PISP + penicillin-resistant S. pneumoniae: PRSP) was 38.4% being consistent with that in 1999 (34.7%). PRSP accounted for 11.0% of the total, being more than that in 1999 (3.0%). Carbapenems had strong activities against S. pneumoniae. Especially, panipenem inhibited the growth of all 73 strains at 0.125 microgram/ml. Generally, all drugs had strong activities against H. influenzae with MIC80s of 8 micrograms/ml or less. The drug that had the strongest activity against H. infiuenzae was levofloxacin, which inhibited the growth of 94 of the 99 strains at 0.063 microgram/ml. Tobramycin had a strong activity against P. aeruginosa (both mucoid and non-mucoid) with MIC80 of 1 microgram/ml. The mucoid strain was little isolated (14 strains) but the susceptibilities to all drugs were better than the non-mucoid strain. K. pneumoniae showed good susceptibilities to all drugs except ampicillin and the MIC80S were 2 micrograms/ml or less. Particularly, cefpirome, cefozopran, and levofloxacin had strong bactericidal activities against K. pneumoniae with MIC80s of 0.125 microgram/ml, and cefotiam, second-generation cephems, also had a favorable activity being MIC80 of 0.25 microgram/ml. Also, all drugs generally had strong activities against M. (B.) catarrhalis. MIC80s of all drugs were 2 micrograms/ml or less. The drug having the strongest activity was imipenem and levofloxacin inhibiting all 21 strains at 0.063 microgram/ml. Most of the patients with respiratory infection were aged 70 years or older, accounting for approximately a half of the total (44.4%). As for the incidence by the diseases, bacterial pneumonia and chronic bronchitis were the highest, being noted in 38.0% and 31.7% of all the patients, respectively. The bacteria frequently isolated from the patients with bacterial pneumonia were S. aureus (18.3%) and S. pneumoniae (16.1%). In contrast, H. infiuenzae (20.4%) and P. aeruginosa (both mucoid and non-mucoid: 16.7%) were frequently isolated from the patients with chronic bronchitis. Before the drug administration, the bacteria frequently isolated from all the patients were S. pneumoniae (24.3%) and H. infiuenzae (26.7%). The frequency of isolated S. pneumoniae tended to decrease with the increase in the number of administration days while that of isolated H. infiuenzae did not. The frequency of isolated P. aeruginosa tended to increase with the duration of administration. The isolated bacteria were comparable between the patients already treated with penicillins and cephems. In the patients treated with aminoglycosides, macrolides, and quinolones, P. aeruginosa was most frequently isolated (33.3 to 40.0%).     

卡泊芬净对生物膜态白色念珠菌体外抑菌作用的试验研究

目的:检测卡泊芬净对生物膜态白色念珠菌分离株的抑菌作用,探讨临床治疗其相关感染的最适治疗剂量。方法:分别测定卡泊芬净对10株白色念珠菌临床株游离态及生物膜态的半数抑菌浓度(MIC50),并对比观察不同浓度卡泊芬净作用下白色念珠菌的增殖活性。结果:卡泊芬净对游离态白色念珠菌的MIC50为0.125～0.5mg.L-1,对生物膜态白色念珠菌的MIC50为0.25～256mg.L-1,当卡泊芬净浓度高于白色念珠菌MIC50时,全部游离态白色念珠菌的增殖活性几乎完全受到抑制,但有7株生物膜态白色念珠菌的增殖活性再次增强,且大于阳性对照的50%。结论:卡泊芬净对生物膜态白色念珠菌有抑菌作用,但并不呈浓度依赖性,当其用于治疗生物膜态白色念珠菌相关感染时的最适治疗剂量有待临床研究验证。     

Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (2001)

From October 2001 to September 2002, we collected the specimen from 370 patients with lower respiratory tract infections in 16 institutions in Japan, and investigated the susceptibilities of the isolated bacteria to various antibacterial agents and antibiotics and patients' characteristics. Of 458 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in inflammation, 456 strains were investigated. The breakdown of the isolated bacteria were: Staphylococcus aureus 69, Streptococcus pneumoniae 72, Haemophilus influenzae 85, Pseudomonas aeruginosa (non-mucoid) 44, P. aeruginosa (mucoid) 13, Klebsiella pneumoniae 32, Moraxella subgenus Branhamella catarrhalis 32, and others. Of 69 S. aureus strains, those with 4 micrograms/mL or more of MIC of oxacillin (methicillin-resistant S. aureus: MRSA) occupied 43.5%. Vancomycin and arbekacin showed the most potent activities against MRSA as observed in 2000. The frequency of S. pneumoniae exhibiting low sensitivity to penicillin (penicillin-intermediate S. pneumoniae: PISP + penicillin-resistant S. pneumoniae: PRSP) was 59.7% and both rates of PISP and PRSP were the highest after 1992. Carbapenems had strong activities against S. pneumoniae. Especially, panipenem and imipenem inhibited the growth of all 72 strains at 0.125 and 0.5 microgram/mL, respectively. Generally, all drugs had strong activities against H. influenzae with MIC90s of 16 micrograms/mL or less. The drug that had the strongest activity against H. influenzae was levofloxacin, which inhibited the growth of 80 of the 85 strains at 0.063 microgram/mL. Against P. aeruginosa mucoid strain, meropenem had a strong activity with MIC90 of 0.5 microgram/mL while, against non-mucoid strain, tobramycin had a strong activity with MIC90 of 2 micrograms/mL. K. pneumoniae showed good susceptibilities to all drugs except ampicillin and minocycline, and the MIC90s were 4 micrograms/mL or less. Particularly, cefmenoxime, cefpirome, and imipenem had the strongest activity (MIC90: 0.125 microgram/mL), and cefozopran had a strong activity, inhibiting the growth of all strains at 0.25 microgram/mL. Also, all drugs generally had strong activities against M. (B.) catarrhalis. MIC90s of all drugs were 4 micrograms/mL or less. The drug that had the strongest activity was minocycline and levofloxacin inhibiting all 32 strains at 0.063 microgram/mL. Most of the patients with respiratory infection were aged 70 years or older, accounting for approximately a half of the total (40.5%). As for the incidence by the diseases, bacterial pneumonia and chronic bronchitis were the highest, being noted in 39.2% and 37.3% of all the patients, respectively. The bacteria frequently isolated from the patients with bacterial pneumonia were S. aureus (19.3%) and S. pneumoniae (19.9%). In contrast, H. influenzae (22.0%) were frequently isolated from the patients with chronic bronchitis. Before the drug administration, the bacteria frequently isolated from the patients were S. pneumoniae (20.8%) and H. influenzae (21.5%). S. pneumoniae and H. influenzae decreased after the initiation of drug administration while S. aureus increased. The isolation frequency of P. aeruginosa was higher after than before the initiation of drug administration. The bacteria were frequently isolated from the patients who had already treated with cephems were S. aureus and P. aeruginosa. From the patients who had already treated with macrolides, S. pneumoniae was the most frequently isolated while S. aureus was the most frequently isolated from the patients pre-treated with quinolones.     

头孢哌酮及不同配比头孢哌酮/舒巴坦的体外抗菌活性研究

目的研究头孢哌酮（CPZ）及不同配比头孢哌酮/舒巴坦（CPZ/SBT）对临床分离致病菌的体外抗菌活性,为临床提供用药依据。方法采用微量稀释法测定CPZ及不同配比CPZ/SBT（1∶1,2∶1）对90株致病菌的最低抑菌浓度（MIC）,并统计MIC范围（MICr）,MIC几何均数（MICg）,50%抑菌浓度（MIC50）、90%抑菌浓度（MIC90）,描记浓度-累积抑菌率曲线。结果不同配比CPZ/SBT的MICg,MIC50,MIC90均较CPZ明显下降,浓度-累积抑菌率曲线比CPZ左移,但不同配比CPZ/SBT之间无明显差别。结论CPZ/SBT可明显提高CPZ的抗菌作用,1∶1配比的CPZ/SBT与2∶1配比者抗菌活性相似,使用2∶1配比的CPZ/SBT较1∶1配比者更安全、经济。     

In vitro activity of a new semisynthetic echinocandin, micafungin, against clinical isolates of Candida species isolated in Tenri Hospital

We have examined the antifungal activities of the available antifungal agents including micafungin (MCFG), one of the echinocandin antifungal group, against 92 yeast-like fungi isolated at our hospital during a 3-month period from November 2002 to February 2003. Determination of the antifungal susceptibility was conducted in conformity with the Standards of the Japanese Society for Medical Mycology. The MIC 80% of the antifungal agents against 4 fungi species including C. albicans (55 strains), C. tropicalis (20 strains), C. glabrata (8 strains), C. krusei (5 strains) were as follows; MCFG: 0.03-0.125 microgram/ml, amphotericin-B: 0.125-0.25 microgram/ml, 5-fluorocytosine: 0.125-16 micrograms/ml, itraconazole: 0.25-2 micrograms/ml, fluconazole: 0.5-32 micrograms/ml. The isolation rate of the drug-resistant fungi was 20% for the fluconazole (FLCZ)-resistant C. tropicalis and 33% when including the susceptible dose dependent (S-DD) class. The rate was 5% for FLCZ-resistant strains of C. albicans and 11% when including the S-DD class. However, MCFG was shown to have an excellent antifungal activity against those azole-resistant strains of Candida species. An analysis of the randomly amplified polymorphic DNA pattern (RAPD) was carried out to assess the fingerprinting of the azole-resistant strains. The results demonstrated a common pattern in 3 of the 6 strains of C. tropicalis that showed MIC of > or = 16 micrograms/ml for fluconazole, while all of the 6 strains of C. albicans demonstrated their respective patterns.