Relation between the Antimicrobial Susceptibility of Clinical Isolates of Pseudomonas aeruginosa from Respiratory Specimens and Antimicrobial Use Density (AUD) from 2005 through 2008
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概要
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Objective To examine the relation between annual trends in the antimicrobial susceptibility of Pseudomonas aeruginosa and drug usage, we compared annual changes in the susceptibility rates of P. aeruginosa clinical isolates during a 4-year period and annual trends in the overall usage of antimicrobials during the same period. Methods We studied annual trends in MIC90/MIC50, antimicrobial use density (AUD), and antimicrobial susceptibility rates based on clinical breakpoints for 150 strains of P. aeruginosa isolated from respiratory specimens at Dokkyo Medical University Hospital from 2005 through 2008. Results The MIC90/MIC50 of antimicrobials effective against P. aeruginosa in years 2005, 2006, 2007, and 2008 were as follows: imipenem, 32/2, 32/1, 8/2, and 16/1 μg/mL; meropenem, 8/1, 8/1, 4/0.5, and 4/0.5 μg/mL; and biapenem, 16/1, 32/0.5, 4/0.5, and 8/0.5 μg/mL, indicating that susceptibility to carbapenems increased slightly. The MIC90/MIC50 was 4/0.25, 2/0.125, 1/0.125, and 2/0.25 μg/mL for ciprofloxacin, 8/4, 8/4, 4/4, and 8/4 μg/mL for amikacin, 64/16, 64/16, 64/16, and 64/16 μg/mL for sulbactam/cefoperazone, 8/2, 16/2, 32/2, and 8/2 μg/mL for ceftazidime, indicating little change. The AUDs of fourth-generation cephalosporins increased from 2005 to 2008 (16.2, 18.4, 28.0, and 23.0), while the AUDs of carbapenems decreased (25.7, 23.7, 10.9, and 12.5). Conclusion The decrease in the AUDs of carbapenems was associated with increased susceptibility rates of P. aeruginosa to carbapenem derivatives. A continuous understanding of trends in the resistance of P. aeruginosa and various other pathogens is essential for designing countermeasures against nosocomial infections, including the proper and effective use of antimicrobials.
著者
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Hirata Hirokuni
Department of Pulmonary Medicine and Clinical Immunology, Dokkyo University School of Medicine
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Fukushima Fumiya
Department Of Internal Medicine Shioya General Hospital
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Sugiyama Kumiya
Department Of Pulmonary Medicine And Clinical Immunology Dokkyo University School Of Medicine
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Hirata Hirokuni
Department Of Pulmonary Medical And Clinical Immunology Dokkyo University School Of Medicine
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Tatewaki Masamitsu
Department Of Pulmonary Medicine And Clinical Immunology Dokkyo Medical University
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Fukushima Yasutsugu
Department Of Pulmonary Medicine And Clinical Immunology Dokkyo Medical University
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Ishii Yoshiki
Department Of Biology Faculty Of Science Kobe University
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Fukuda Takeshi
Department Of Applied Chemistry And Biotechnology Graduate School Of Engineering University Of Fukui
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Kamiya Kuniyoshi
Department Of Pulmonary Medicine And Clinical Immunology Dokkyo University School Of Medicine
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Yamada Issei
Department Of Pulmonary Medicine And Clinical Immunology Dokkyo University School Of Medicine
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Hayashi Yumeko
Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine
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Hayashi Yumeko
Department of Pulmonary Medicine and Clinical Immunology, Dokkyo University School of Medicine
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