尿路感染症分離菌の年次的変遷と薬剤感受性の検討 (ニューキノロン系を中心として)

Abstract

'88年1月より'91年12月までの4年間に尿路感染(UTI)と診断された患者からの尿中分離菌を集計し, 菌頻度の年次的変遷とニューキノロン系を中心とした感受性を検討した。外来単純性UTIからの分離菌総数は352株でE. coliが毎年約90%を占めた。外来複雑性の671株ではEnterococcus sp, fungi, other GNRおよび前記後二者が多く, やはり後二者が増加傾向である。E. coliはABPC, preoteus spはMINO, 以外には感受性を示す。P aeruginosaはG.M.以外の薬剤には耐性株が多く, S. aureusはMINO以外に耐性株が多い。一般に入院複雑性UTIではNFLXの感受性の有意の低下がある。ニューキノロン系薬剤では各菌種に対しTFLXが最も良好な抗菌力を示し, ついでCPFXで他の薬剤より1～2管程度低いMIC80値を示した

Statistical analyses were conducted on bacterial strains isolated from the urine of patients with urinary tract infections (UTI) in the Department of Urology at Aichi Medical University from January 1988 through December 1991. The drug sensitivity of the bacterial strains isolated from patients with complicated UTI between 1988 and 1991 was analyzed and compared. Among the outpatients with uncomplicated UTI, a total of 352 strains were isolated. E. coli was isolated the most frequently (90.1%). Among the outpatients with complicated UTI, a total of 829 strains were isolated. Enterococcus sp. was isolated the most frequently (21.2%). P. aeruginosa and S. aureus showed a tendency to increase. Among the inpatients with complicated UTI, a total of 671 strains were isolated. Enterococcus sp. was isolated the most frequently (22.5%). P. aeruginosa and S. aureus showed a tendency to increase, while E. coli and Enterobacter sp. showed a tendency to decrease. E. coli was highly sensitive to all drugs except ampicillin (ABPC). Proteus sp. and Klebsiella sp. were highly sensitive to norfloxacin (NFLX). P. aeruginosa was highly sensitive to gentamicin (GM). The frequency of NFLX-sensitive P. aeruginosa significantly dropped from 84.6% to 40.9% among the outpatients (P < 0.01), and from 75.0% to 44.4% among inpatients (P < 0.05). S. aureus was highly sensitive only to minocycline (MINO). The frequency of NFLX-sensitive S. aureus significantly dropped from 66.6% to 23.3% among inpatients (P < 0.05). Enterococcus sp. was highly sensitive to ABPC and MINO. Of the new quinolones, tosufloxacin (TFLX) had the strongest antimicrobial activity followed by (ciprofloxacin) CPFX on all the bacterial strains tested.