尿路感染症におけるβ-ラクタマーゼ産生菌の動向とスルペラゾンの臨床的効果の検討

Abstract

1) 1987年5月～7月の間に県下4施設において, 尿中分離菌460株中グラム陽性菌135株, グラム陰性菌325株で, βラクタマーゼ産生菌は全株の46.7%, グラム陽性菌の14%, グラム陰性菌の60%に認めた.2) P. aeruginosa, E. coli, S. marcescensはグラム陰性菌中に占める頻度, β-ラクタマーゼ産生頻度から代表的なものであった.又分離検出頻度は低いがβ-ラクタマーゼ産生頻度の高率なものは, Acintobacter, Klebsiella, Citrobacter, Enterobacterであった.3) β-ラクタマーゼ産生頻度の高い6菌種では, スルペラゾンに対し74%に感受性をみた.E. coli, Klebsiella, S. epidermidis, P. aeruginosaでは比較的良好であった.4)複雑性尿路感染症26例にスルペラゾンを投与し, 有効率73.1%, 分離菌消失率63%を得た.in vivoのPseudomonas, Serratiaの消失率はそれぞれ50%であった

Clinical survey of microorganisms isolated from urinary tract infection (UTI) was carried out at the four major hospitals in Mie Prefecture from May to July, 1987, and production of beta-lactamase of the microorganisms was determined by the acidimetric method, "beta-checker". Among the total of 460 strains isolated from urine samples, 135 of gram positive cocci and 325 of gram negative rods were contained. Sixty percent of the gram negative rods and 14% of gram positive cocci produced beta-lactamase. Pseudomonas aeruginosa, E. coli and Serratia marcescens were representative organisms which produced beta-lactamase. Acinetobacter, Klebsiella, Enterobacter and Citrobacter species produced beta-lactamase at a higher rate but those were not so frequently isolated. In the sensitivity test to Sulperazone, the representative organisms isolated from urine, as a whole, had a sensitivity of 74% and E. coli, Klebsiella, S. epidermidis and Pseudomonas aeruginosa were highly sensitive, while Enterobacter cloacae and Serratia marcescens showed low sensitivity. The clinical efficacy of Sulperazone was evaluated in 26 patients with complicated UTI. Overall effectiveness rate and eradication rate of beta-lactamase production organisms were 73.1 and 63%, respectively. Sulperazone is concluded to be a useful antibiotic for treating complicated UTI induced by beta-lactamase production organisms from the point of microbiology and safety.