[Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibacterial agents (2008)].

Abstract

From October 2008 to September 2009, we collected the specimen from 374 patients with lower respiratory tract infections in 15 institutions in Japan, and investigated the susceptibilities of isolated bacteria to various antibacterial agents and patients' characteristics. Of 423 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in infection, 421 strains were examined. The isolated bacteria were: Staphylococcus aureus 78, Streptococcus pneumoniae 78, Haemophilus influenzae 89, Pseudomonas aeruginosa (non-mucoid) 61, P. aeruginosa (mucoid) 19, Klebsiella pneumoniae 28, and Moraxella catarrhalis 32. Of 78 S. aureus strains, those with 2 μg/mL or less of MIC of oxacillin (methicillin-susceptible S. aureus: MSSA) and those with 4 μg/mL or more of MIC of oxacillin (methicillin-resistant S. aureus: MRSA) were 34 (43.6%) and 44 (56.4%) strains, respectively. Against MSSA, imipenem had the most potent antibacterial activity and inhibited the growth of all strains at 0.063 μg/mL or less. Against MRSA vancomycin and arbekacin showed the potent activity and inhibited the growth of all the strains at 1 and 2 μg/mL, respectively. Linezolid also showed the great activity and inhibited the growth of all the strains at 1 μg/mL. Carbapenems and penems showed the most potent activities against S. pneumoniae and panipenem inhibited the growth of all the strains at 0.125 μg/mL. Imipenem and faropenem also had a preferable activity and inhibited the growth of all the strains at 0.25 and 1 μg/mL, respectively. In contrast, there were high-resistant strains (MIC: > 128 μg/mL) for erythromycin (43.6%) and clindamycin (19.2%). Against H. influenzae, levofloxacin showed the most potent activity and its MIC90 was 0.063 μg/mL or less. Tobramycin showed the most potent activity against P. aeruginosa (mucoid) and its MIC90 was 2 μg/mL. Against the non-mucoid type of P. aeruginosa, tobramycin and ciprofloxacin had the most potent activity and its MIC90 was 2 μg/mL. Against K. pneumoniae, cefozopran had the most potent activity and inhibited the growth of all the strains at 0.063 μg/mL or less. All the antibacterial agents except ampicillin generally showed a potent activity against M. catarrhalis and the MIC90 of them were 2 μg/mL or less. The majority number (57.7%) of the patients with respiratory infection were aged 70 years or older. Bacterial pneumonia and chronic bronchitis accounted for 40.9% and 32.9% of all the respiratory infection, respectively. The bacteria frequently isolated from the patients with bacterial pneumonia were S. aureus (20.5%), S. pneumoniae (21.1%), and H. influenzae (22.8%). S. aureus (21.7%) and P. aeruginosa (24.6%) also were frequently isolated from the patients with chronic bronchitis. The bacteria frequently isolated from the patients were S. pneumoniae (23.4%) and H. influenzae (25.1%) before administration of the antibacterial agents. The bacteria frequently isolated from the patients previously treated with cephems and macrolides were P. aeruginosa, and the isolation frequencies were 41.4% and 40.0%, respectively.