非特異性尿路感染症の細菌学的検索 (附: Nalidixic Acidウイントマイロンの尿路感染症への応用)

Abstract

The report deals with analysis of the results of sensitivity tests on microorganisms isolated from patients with non-specific urinary tract infections observed during the past 4 years (from July 1961 to June 1965) in our hospital, and therapeutic effects of new chemotherapics, Nalidixic acid (ND), on these patients. 1) Per cent distributions of the 350 str a ins so far isolated were 76.3j% of bacilli, 17.4 % of cocci, 4.3 % of bacilli and cocci mixed and 2.0 ro of fungi. Changes of these strains by year of observation showed a gradual increase in bacilli which became 85.7 % in 1965 and a marked decrease in cocci. Among the bacilli, E. coli occupied about a half and Proteus, Pseudomonas and Klebsiella were then followed. Staphylococci were the major ones among the cocci. Sensitivity te s ts on the isolated bacilli demonstrated the highest sensitivity to KM among broad-spectrum antibiotics. Conspicuous results were evident in the series of Macrolide agents against cocci and KM, ND and Colistin (CS) against bacilli. The rate of resistance was not increased only to KM by year. Based on the results of anti-bacterial abilit y , the first choice should be ND, KM and CS against E. coli and Klebsiella, ND and KM against Proteus, CS against Pseudomonas and KM and CP against Staphylococci. The triple resistance to SM, CP and TC was seen about 20 to 30 % in every different group of bacilli (13.3 % for Klebsiella). Yearly observations on E. coli demonstrated a rapid increase in such triple resistance in recent years. The tetra-resistance to SM, CP, TC and KM was seen in Pseudomonas at higher rate than in other Gram negatve bacilli (17.4 %). 3) Nalidixic acid was adminis t e red to a total of 36 patients with urinary tract infections. Response to the therpy was seen in 100 % of acute cases and 71 % of chronic cases, making 83 % of effectiveness as the total. The majority of E. coli and Proteus infections was successfully treated with Nalidixic acid, while it showed effective results in one of 2 cases of Pseudomonas infection and one of 3 cases of Klebsiella infections, all of those 2 later ones were chronic infections. Gastrointestinal disturban c e was observed in one case as side effect.