Clinical Characteristics of Pneumonia Caused by Penicillin Resistant and Sensitive Streptococcus pneumoniae in Japan

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概要

• 論文の詳細を見る

• Background S. pneumoniae is the leading cause of morbidity and mortality worldwide. β-lactam antibiotics were very effective against S. pneumoniae, however resistance to this class of antibiotic has become an increasing problem. Objectives To assess the clinical differences between penicillin-sensitive and penicillin-resistant pneumococcal pneumonia. Methods The medical records of 306 patients with pneumococcal pneumonia who visited Nagasaki University Hospital or affiliated institutions between January 1997 and December 2001 were retrospectively reviewed. The Pneumonia Severity Index (PSI), sensitivity of S. pneumoniae, antibiotic choices and information on clinical outcome were evaluated. Results Penicillin sensitive and resistant organisms were responsible for 177 (57.7%) and 129 (42.0%) cases of pneumonia, respectively. The median age of patients was 65.5 years, and 72.3% (222) were males. There were no significant differences in the resistance rate between elderly (>65 years) and young patients. The median PSI score was 76. No significant association was observed between the severity of illness and sensitivities of S. pneumoniae. Previous use of beta-lactams in the last 3 months and chronic obstructive pulmonary disease were associated with penicillin resistance. The failure rate of first line antibiotics was significantly higher in the resistant group (22.5%) than in the sensitive group (9.0%). Four of 306 patients died (mortality, 1.3%). Conclusion There were no significant differences clinically between the penicillin-sensitive and penicillin-resistant groups. The failure rate of first line antibiotics was higher in the resistant than in the sensitive group. Thus, the selection of antimicrobial agents should be carefully considered in the context of the patient’s risk factors.

• 日本内科学会,The Japanese Society of Internal Medicineの論文
• 2004-11-01

著者

• Kohno S

  Second Dep. Of Internal Medicine Nagasaki Univ. Graduate School Of Biomedical Sciences Nagasaki Univ

• Hirakata Yoichi

  長崎大学 医学部第二内科学

• Kohno Shigeru

  Second Department of Internal Medicine, Nagasaki University School of Medicine

• Kamihira Shimeru

  長崎大学 医歯薬学総合研究科臨床検査医学講座

• 上平 憲

  長崎大学臨床検査医学

• Miyazaki Yoshitsugu

  Dep. Of Lab. Medicine Nagasaki Univ. Graduate School Of Biomedical Sciences Nagasaki Univ. Hospital

• Yanagihara Katsunori

  長崎大学 医学部第二内科

• Yanagihara Katsunori

  長崎大学 医歯薬学総合研究科臨床検査医学講座

• Yanagihara Katsunori

  Dep. Of Lab. Medicine Nagasaki Univ. Graduate School Of Biomedical Sciences Nagasaki Univ. Hospital

• Yanagihara Katsunori

  Second Dep. Of Internal Medicine Nagasaki Univ. School Of Medicine

• Sugahara Kazuyuki

  長崎大学 医歯薬学総合研究科臨床検査医学講座

• Miyazaki Yoshitsugu

  長崎大学 第二内科

• Miyazaki Y

  Dep. Of Lab. Medicine Nagasaki Univ. Graduate School Of Biomedical Sciences Nagasaki Univ. Hospital

• Kawakami S

  Santen Pharmaceutical Co. Ltd. Nara Research And Development Center:department Of Hospital Pharmacy

• Otsu Yoshiko

  Second Department Of Internal Medicine Nagasaki University Graduate School Of Pharmaceutical Science

• Kohno Shigeru

  長崎大学医学部歯学部附属病院 薬剤部

• TOMONO Kazunori

  Second Department of Internal Medichine, Nagasaki University School of Medicine

• Kawakami S

  Department Of Laboratory Medicine Nagasaki University Graduate School Of Biomedical Sciences

• Sugahara Yazuyuki

  長崎大学 医歯薬学総合研究科臨床検査医学講座

• KADOTA Jun-ichi

  Second Department of Internal Medicine, Nagasaki University

• HIRAKATA Yoichi

  Second Department of Internal Medicine, Nagasaki University School of Medicine

• MIYAZAKI Yoshitsugu

  Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences

• OHNO Hideaki

  Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences

• HIGASHIYAMA Yasuhito

  Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences

• Kadota Jun-ichi

  長崎大学 医歯薬学総合研究科第二内科学

• Kadota J

  Second Department Of Internal Medicine Oita University Faculty Of Medicine

• Sakanaka Koji

  参天製薬奈良研究開発センター

• Hirakata Y

  長崎大学 医学部第二内科学

• Kadota Jun-ichi

  Second Department Of Internal Medicine Faculty Of Medicine Oita University

• Kadota Jun-ichi

  The Second Department Of Internal Medicine Ngasaki University School Of Medicine

• Tomono Kazunori

  Nagasaki Univ. School Of Medicine And Dentistry

• Ohno Hideaki

  The Second Department Of Internal Medicine Nagasaki University School Of Medicine

• Tomono Kazunori

  The Second Department Of Internal Medicine Nagasaki University School Of Medicine

• Tomono K

  Second Department Of Internal Medicine Nagasaki University

• Tomono Kazunori

  Second Department Of Internal Medicine Nagasaki University School Of Medicine

• Higami Yoshikazu

  Department Of Histology And Cell Biology Nagasaki University Graduate School Of Biomedical Sciences

• Tashiro Takayoshi

  Second Department Of Internal Medicine Nagasaki University School Of Medicine

• Tsuchiya Tomoshi

  Division Of Surgical Oncology Nagasaki University Graduate School Of Biomedical Sciences

• Yanagihara Katsunori

  長崎大学 第二内科

• Miyazaki Yoshitsugu

  Second Department Of Internal Medicine Nagasaki University Graduate School Of Biomedical Science

• Miyazaki Yoshitsugu

  The Second Department Of Internal Medicine Nagasaki University School Of Medicine

• Maeda Yasuhiro

  Department Of Hematology Kinki University School Of Medicine

• Hirakata Yoichi

  Department Of Clinical Laboratory Medicine Nagasaki University School Of Medicine

• Kohno Shigeru

  Second Dep. Of Internal Medicine Nagasaki Univ. Graduate School Of Biomedical Sciences Nagasaki Univ

• Kohno Tomoko

  Department Of Molecular Microbiology And Immunology Nagasaki University Graduate School Of Medicine

• Takase Tomiko

  The Secont Departmetn Of Internal Medicine Nagasaki University School Of Medicine

• Yanagihara Katsunori

  Department Of Laboratory Medicine Nagasaki University School Of Medicine

• Yamaguchi Kazunari

  Department Of Safety Research On Blood And Biologics National Institute Of Infectious Diseases

• Miyazaki Yoshitsugu

  Second Department Of Internal Medicine Nagasaki University Graduate School Of Biomedical Sciences

• Harada Yousuke

  Department Of Laboratory Medicine Nagasaki University Graduate School Of Biomedical Sciences

• Miyazaki Yoshitsugu

  Department Of Laboratory Medicine Nagasaki University Graduate School Of Biomedical Sciences Nagasak

• Hara Yukiko

  Department Of Laboratory Medicine Nagasaki University Graduate School Of Biomedical Sciences

• Tsuchiya Tomoshi

  Division Of Surgical Oncology Department Of Surgery Nagasaki University Graduate School Of Biomedical Sciences

• Takase Tomiko

  Division Of Surgical Oncology Department Of Translational Medical Science Nagasaki University Graduate School Of Biomedical Sciences

• Takase Tomiko

  Division Of Surgical Oncology Department Of Surgery Nagasaki University Graduate School Of Biomedical Sciences

• Hirakata Yoichi

  Department Of Clinical Microbiology And Management And Analysis Of Infectious Diseases Tohoku University Graduate School Of Medicine

• Hirakata Yoichi

  Second Department of Internal Medicine, Nagasaki University Graduate School of Medical Science

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