[头孢唑仑对各种临床分离菌抗菌活性的上市后监测--I.革兰氏阳性菌]。

The Japanese journal of antibiotics Pub Date : 2002-02-01
Jun Igari, Toyoko Oguri, Nobuyoshi Hiramatsu, Kazumitsu Akiyama, Tsuneo Koyama
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引用次数: 0

摘要

作为一项上市后监测,我们每年都会评估头孢唑兰(CZOP)(一种头孢类药物)对各种临床分离菌的体外抗菌活性,并将其与其他头孢类药物、氧头孢类药物、青霉素类药物和碳青霉烯类药物的体外抗菌活性进行比较。细菌对 CZOP 的敏感性变化也根据断点 MIC 计算出的耐药率进行了评估。从 1996 年至 2000 年期间每年收集的临床材料中分离出 16 种(1,913 株)革兰氏阳性细菌,包括甲氧西林敏感金黄色葡萄球菌(MSSA;n = 178)、耐甲氧西林金黄色葡萄球菌(MRSA;n = 199)、甲氧西林敏感表皮葡萄球菌(MSSE;n = 98)、耐甲氧西林表皮葡萄球菌(MRSE;n = 98)、耐甲氧西林表皮葡萄球菌(MSSE;n = 98)、耐甲氧西林表皮葡萄球菌(MRSE;n = 98)。表皮葡萄球菌(MRSE;n = 164)、溶血性葡萄球菌(n = 72)、溶血性葡萄球菌(n = 28)、粪肠球菌(n = 206)、粪肠球菌(n = 91)、肠球菌(n = 72)、化脓性链球菌(n = 133)、无乳链球菌(n = 138)、青霉素敏感性肺炎链球菌(PSSP;n = 133)、耐青霉素中间型肺炎链球菌(PISP;n = 138肺炎链球菌(PSSP;n = 133)、耐青霉素中间型肺炎链球菌(PISP;n = 100)、耐青霉素肺炎链球菌(PRSP;n = 29)、千日链球菌群(n = 135)和肽链球菌属(n = 137)。CZOP 对 MSSA 和 MSSE 的抗菌活性与其他头孢菌素相当,对 MRSE 也有效,但对 MRSA 无效。CZOP 对沙普氏菌的抗菌活性与其他头孢菌素相当或更高。然而,与其他头孢菌素一样,CZOP 对溶血性链球菌没有抗菌活性。CZOP 对粪大肠杆菌的抗菌活性与头孢匹罗(CPR)相当,高于其他头孢菌素。与其他药物一样,CZOP 对粪大肠杆菌和阿维菌素没有抗菌活性。CZOP 对化脓性链球菌的抗菌活性与头孢替安(CTM)、头孢吡肟(CFPM)和头孢吡肟酸钠(CPR)一样强,而对无菌性链球菌的抗菌活性也优于头孢替安(CTM)、头孢吡肟(CFPM)和头孢吡肟酸钠(CPR)。CZOP 和其他头孢菌素对苄青霉素最敏感的毫雷氏菌也有较好的抗菌活性。CZOP 对百日咳链球菌属的抗菌活性较好,但弱于头孢唑啉、CTM 和头孢美唑。根据 CZOP 的断点 MIC 值估算,MRSA 的耐药率为 96.5%,PRSP 为 93.1%,PISP 为 60.0%,溶血性链球菌为 40.3%,粪大肠杆菌为 22.3%,MRSE 为 15.9%。这些抗药性比率与对 CFPM 的抗药性比率相似,但粪大肠杆菌对 CFPM 的抗药性比率为 90.8%。粪肠球菌耐药性比率的差异表明,CZOP 成功地保持了对该菌种的抗菌活性。总之,CZOP 对革兰氏阳性菌的抗菌活性没有明显的年度变化。不过,PISP 和 PRSP 对 CZOP 的敏感性有所下降。
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[Post-marketing surveillance of antibacterial activities of cefozopran against various clinical isolates--I. Gram-positive bacteria].

As a post-marketing surveillance, the in vitro antibacterial activities of cefozopran (CZOP), an agent of cephems, against various clinical isolates were yearly evaluated and compared with those of other cephems, oxacephems, penicillins, and carbapenems. Changes in the bacterial sensitivity for CZOP were also evaluated with the resistance ratio calculated with breakpoint MIC. Sixteen species (1,913 strains) of Gram-positive bacteria were isolated from the clinical materials annually collected from 1996 to 2000, and consisted of methicillin-susceptible Staphylococcus aureus (MSSA; n = 178), methicillin-resistant S. aureus (MRSA; n = 199), methicillin-susceptible Staphylococcus epidermidis (MSSE; n = 98), methicillin-resistant S. epidermidis (MRSE; n = 164), Staphylococcus haemolyticus (n = 72), Staphylococcus saprophyticus (n = 28), Enterococcus faecalis (n = 206), Enterococcus faecium (n = 91), Enterococcus avium (n = 72), Streptococcus pyogenes (n = 133), Streptococcus agalactiae (n = 138), penicillin-susceptible Streptococcus pneumoniae (PSSP; n = 133), penicillin-intermediate resistant S. pneumoniae (PISP; n = 100), penicillin-resistant S. pneumoniae (PRSP; n = 29), Streptococcus milleri group (n = 135) and Peptostreptococcus spp. (n = 137). CZOP possessed comparable antibacterial activities against MSSA and MSSE to other cephems, and was also effective on MRSE but not on MRSA. An antibacterial activity of CZOP against S. saprophyticus was comparable to or higher than other cephems. CZOP, however, did not indicate an antibacterial activity against S. haemolyticus, just like other cephems. An antibacterial activity of CZOP against E. faecalis was comparable to cefpirome (CPR) and higher than other cephems. No antibacterial activity of CZOP against E. faecium and E. avium was observed, just like other drugs. An antibacterial activity of CZOP against S. pyogenes was as potent as that of cefotiam (CTM), cefepime (CFPM) and CPR, and that against S. agalactiae was also preferable. CZOP and other cephems also had a preferable antibacterial activity against S. milleri group that was most sensitive to benzylpenicillin. An antibacterial activity of CZOP against Peptostreptococcus spp. was preferable but weaker than that of cefazolin, CTM and cefmetazole. The resistance ratio estimated with breakpoint MIC of CZOP was 96.5% in MRSA, 93.1% in PRSP, 60.0% in PISP, 40.3% in S. haemolyticus, 22.3% in E. faecalis, and 15.9% in MRSE. Those resistance ratios were similar to those for CFPM, but E. faecalis showed 90.8% resistance for CFPM. The difference in the resistance ratio of E. faecalis demonstrated that CZOP successfully maintained its antibacterial activity against this species. In conclusion, no remarkable annual change in the antibacterial activities of CZOP against the Gram-positive bacteria was observed. The sensitivities of PISP and PRSP to CZOP, however, was suggested to be decreasing.

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[Yearly changes in antibacterial activities of cefozopran against various clinical isolates between 1996 and 2000--I. Gram-positive bacteria]. [Yearly changes in antibacterial activities of cefozopran against various clinical isolates between 1996 and 2000--II. Gram-negative bacteria]. [Post-marketing surveillance of antibacterial activities of cefozopran against various clinical isolates--I. Gram-positive bacteria]. [Post-marketing surveillance of antibacterial activities of cefozopran against various clinical isolates--II. Gram-negative bacteria]. [Antimicrobial activities of carbapenems and fourth generation cephems against clinically isolated strains].
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