Nationwide surveillance of antimicrobial susceptibility patterns of pathogens isolated from surgical site infections (SSI) in Japan

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• 作者：Yoshio Takesue (1) (2) (29)
  Akira Watanabe (1)
  Hideaki Hanaki (3)
  Shinya Kusachi (1) (4)
  Tetsuro Matsumoto (1)
  Aikichi Iwamoto (1)
  Kyoichi Totsuka (1)
  Keisuke Sunakawa (1)
  Morimasa Yagisawa (1)
  Junko Sato (1)
  Toyoko Oguri (1)
  Kunio Nakanishi (1)
  Yoshinobu Sumiyama (5) (6)
  Yuko Kitagawa (5) (7)
  Go Wakabayashi (8)
  Isamu Koyama (9)
  Katsuhiko Yanaga (10)
  Toshiro Konishi (11)
  Ryoji Fukushima (12)
  Shiko Seki (13)
  Shun Imai (14)
  Tsunehiro Shintani (15)
  Hiroki Tsukada (16)
  Kazuhiro Tsukada (17)
  Kenji Omura (18)
  Hiroshige Mikamo (19)
  Hiromitsu Takeyama (20)
  Masato Kusunoki (21)
  Shoji Kubo (22)
  Junzo Shimizu (23)
  Toshihiro Hirai (24)
  Hiroki Ohge (25)
  Akio Kadowaki (26)
  Kohji Okamoto (27)
  Katsunori Yanagihara (28)
  
• 关键词：Surgical site infections ; Surveillance ; Antibiotic susceptibility ; Bacteroides fragilis group
• 刊名：Journal of Infection and Chemotherapy
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：18
• 期：6
• 页码：816-826
• 参考文献：1. http://www.kankyokansen.org:jhais-ssi-symmary.pdf. Accessed 10 Jan 2012.
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  15. Montravers P, Lepape A, Dubreuil L, Gauzit R, Pean Y, Benchimol D, et al. Clinical and microbiological profiles of community-acquired and nosocomial intra-abdominal infections: results of the French prospective, observational EBIIA study. J Antimicrob Chemother. 2009;63:785-4. CrossRef
  16. Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJC, Baron EJ, et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Disease Society of America. Clin Infect Dis. 2010;50:133-4. CrossRef
  17. Nakamura T, Komatsu M, Yamasaki K, Fukuda S, Miyamoto Y, Higuchi T, et al. Epidemiology of / Escherichia coli, / Klebsiella species, and / Proteus mirabilis strains producing extended-spectrum β-lactamases from clinical samples in the Kinki Region of Japan. Am J Clin Pathol. 2012;137:620-. CrossRef
  18. Takesue Y, Nakajima K, Takahashi Y, Ichiki K, Ishihara M, Wada Y, et al. Clinical characteristics of vancomycin minimum inhibitory concentration of 2?μg/ml methicillin-resistant / Staphylococcus aureus strains isolated from patients with bacteremia. J Infect Chemother. 2011;17:52-. CrossRef
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• 作者单位：Yoshio Takesue (1) (2) (29)
  Akira Watanabe (1)
  Hideaki Hanaki (3)
  Shinya Kusachi (1) (4)
  Tetsuro Matsumoto (1)
  Aikichi Iwamoto (1)
  Kyoichi Totsuka (1)
  Keisuke Sunakawa (1)
  Morimasa Yagisawa (1)
  Junko Sato (1)
  Toyoko Oguri (1)
  Kunio Nakanishi (1)
  Yoshinobu Sumiyama (5) (6)
  Yuko Kitagawa (5) (7)
  Go Wakabayashi (8)
  Isamu Koyama (9)
  Katsuhiko Yanaga (10)
  Toshiro Konishi (11)
  Ryoji Fukushima (12)
  Shiko Seki (13)
  Shun Imai (14)
  Tsunehiro Shintani (15)
  Hiroki Tsukada (16)
  Kazuhiro Tsukada (17)
  Kenji Omura (18)
  Hiroshige Mikamo (19)
  Hiromitsu Takeyama (20)
  Masato Kusunoki (21)
  Shoji Kubo (22)
  Junzo Shimizu (23)
  Toshihiro Hirai (24)
  Hiroki Ohge (25)
  Akio Kadowaki (26)
  Kohji Okamoto (27)
  Katsunori Yanagihara (28)
  
  1. Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
  2. Hyogo College of Medicine Hospital, Hyogo, Japan
  29. Department of Infection Control and Prevention, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
  3. Kitasato University Institute, Tokyo, Japan
  4. Toho University Medical Center Ohashi Hospital, Tokyo, Japan
  5. Japan Society for Surgical Infection, Tokyo, Japan
  6. Toho University, Tokyo, Japan
  7. Keio University Hospital, Tokyo, Japan
  8. Iwate Medical University Hospital, Iwate, Japan
  9. Saitama Medical University International Medical Center, Saitama, Japan
  10. The Jikei University Hospital, Tokyo, Japan
  11. NTT Medical Center Tokyo, Tokyo, Japan
  12. Teikyo University Hospital, Tokyo, Japan
  13. National Hospital Organization Tokyo Medical Center, Tokyo, Japan
  14. Hiratsuka City Hospital, Kanagawa, Japan
  15. Shizuoka Red Cross Hospital, Shizuoka, Japan
  16. Niigata City General Hospital, Niigata, Japan
  17. Toyama University Hospital, Toyama, Japan
  18. Koseiren Takaoka Hospital, Toyama, Japan
  19. Aichi Medical University Hospital, Aichi, Japan
  20. Nagoya City University Hospital, Aichi, Japan
  21. Mie University Hospital, Mie, Japan
  22. Osaka City University Hospital, Osaka, Japan
  23. Toyonaka Municipal Hospital, Osaka, Japan
  24. Kawasaki Medical School Hospital, Okayama, Japan
  25. Hiroshima University Hospital, Hiroshima, Japan
  26. Sanin Rosai Hospital, Tottori, Japan
  27. University of Occupational and Environmental Health, Kitakyushu, Japan
  28. Nagasaki University Hospital, Nagasaki, Japan
  
• ISSN：1437-7780

文摘

To investigate the trends of antimicrobial resistance in pathogens isolated from surgical site infections (SSI), a Japanese surveillance committee conducted the first nationwide survey. Seven main organisms were collected from SSI at 27 medical centers in 2010 and were shipped to a central laboratory for antimicrobial susceptibility testing. A total of 702 isolates from 586 patients with SSI were included. Staphylococcus aureus (20.4?%) and Enterococcus faecalis (19.5?%) were the most common isolates, followed by Pseudomonas aeruginosa (15.4?%) and Bacteroides fragilis group (15.4?%). Methicillin-resistant S. aureus among S. aureus was 72.0?%. Vancomycin MIC 2?μg/ml strains accounted for 9.7?%. In Escherichia coli, 11 of 95 strains produced extended-spectrum β-lactamase (Klebsiella pneumoniae, 0/53 strains). Of E. coli strains, 8.4?% were resistant to ceftazidime (CAZ) and 26.3?% to ciprofloxacin (CPFX). No P. aeruginosa strains produced metallo-β-lactamase. In P. aeruginosa, the resistance rates were 7.4?% to tazobactam/piperacillin (TAZ/PIPC), 10.2?% to imipenem (IPM), 2.8?% to meropenem, cefepime, and CPFX, and 0?% to gentamicin. In the B. fragilis group, the rates were 28.6?% to clindamycin, 5.7?% to cefmetazole, 2.9?% to TAZ/PIPC and IPM, and 0?% to metronidazole (Bacteroides thetaiotaomicron; 59.1, 36.4, 0, 0, 0?%). MIC90 of P. aeruginosa isolated 15?days or later after surgery rose in TAZ/PIPC, CAZ, IPM, and CPFX. In patients with American Society of Anesthesiologists (ASA) score ?, the resistance rates of P. aeruginosa to TAZ/PIPC and CAZ were higher than in patients with ASA ?. The data obtained in this study revealed the trend of the spread of resistance among common species that cause SSI. Timing of isolation from surgery and the patient’s physical status affected the selection of resistant organisms.