levofloxacin (LVFX) LVFX LVFX LVFX Key words: Levofloxacin Escherichia coli LVFX levofloxacin (LVFX) Vol. 18 No
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1 levofloxacin (LVFX) LVFX (MIC: 4 mg/ml) LVFX LVFX Key words: Levofloxacin Escherichia coli 1) 2 5) 6) ( ) TEL: FAX: ogura@tamanan-hp.com LVFX levofloxacin (LVFX) LVFX Vol. 18 No
2 cfu/ml 2. MicroScan Walk/Away, NC5J DADE ampicillin (ABPC), piperacillin (PIPC), cefazolin (CEZ), cefotiam (CTM), cefotaxime (CTX), ceftazidime (CAZ), cefmetazole (CMZ), cefaclor (CCL), flomoxef (FMOX), sulbactam/cefoperazone (SBT/CPZ), cefpirome (CPR), gentamicin (GM), amikacin (AMK), imipenem/ cilastatin (IPM/CS), minocycline (MINO), sulfamethoxazole/trimethoprim ST fosfomycin (FOM), levofloxacin (LVFX) 18 LVFX (BP) CLSI (Clinical and Laboratory Standards Institute) 7) 2 mg/ml 4 mg/ml / CLSI E. coli ATCC CLSI I R PIPC ABPC ABPC CTM, CMZ, FMOX R 1 CTM LVFX, ABPC, CEZ, CTM, MINO, GM, ST, FOM LVFX 26 LVFX 94 LVFX 2 (i) (ii) (iii) (iv) LVFX 1. levofloxacin 2 Vol. 18 No
3 (13.4 ) 1 LVFX (15.7 ) (16.5 ) (17.4 ) (15.5 ) (11.6 ) LVFX 27 (21.6 ) (6.3 ) (21.4 ) (17.9 ) (23.5 ) (36.8 ) 2. MicroScan Walk/Away 18 2 ABPC, PIPC, GM, MINO, ST LVFX FOM 7 CTX, CAZ, CCL, SBT/CPZ, CPR, AMK, IPM/CS Levofloxacin ( ) LVFX LVFX, ABPC, CEZ, CTM, MINO, ST, FOM 2( 7.4) LVFX, ABPC, CEZ, GM, MINO, ST 2( 7.4) LVFX, ABPC, GM, MINO, ST 5( 18.5) LVFX, ABPC, MINO, ST, FOM 2( 7.4) LVFX, ABPC, GM, ST 5( 18.5) LVFX, ABPC, ST 6( 22.2) LVFX, MINO, ST 3( 11.1) LVFX, GM 1( 3.7) LVFX 1( 3.7) Subtotal 27(100.0) ABPC PIPC CTM CMZ FMOX 1 LVFX (n 27) LVFX ABPC ST 3 6 (22.2 ) LVFX ABPC GM ST 4 5 (18.5 ) MINO 5 5 (18.5 ) LVFX 1 3. LVFX i) ii) iii) iv) Vol. 18 No
4 LVFX LVFX (n 94) LVFX (n 26) p Odds : p 0.05 : p LVFX LVFX (p ) (p ) p LVFX Odds (8.5 ) p Odds LVFX 11 b- 14 LVFX (p ) LVFX LVFX LVFX 2) ) ) ) ) LVFX 4 Vol. 18 No
5 225 9) CPFX LVFX ) LVFX 2000 LVFX ABPC LVFX LVFX Odds 3 10 LVFX CTX ESBL ESBL 11) 1) p ) Yamaguchi, K., A. Ohno, Investigation of the susceptibility trends in Japan to fluoroquinolons and other antimicrobial agents in a nationwide collection of clinicates: A longitudinal analysis from 1994 to Diagn. Microbial. Infect. Dis ) : ) : ) : ) Mazzariol, A., Y. Tokue, T. M. Kanegawa, et al High-level fluoroquinoline-resistant clinical isolates of Escherichia coli overproduce multidrug e%ux protein AcrA. Antimicrob. Agents and Chemother. 44: ) Clinical and Laboratory Standards Institute Performance standards for antimicrobial susceptibility testing: 15th informational supplement CLSI/NCCLS M100 S15. Clinical Laboratory Standards Institute, Wayne, Pa, USA. 8) : ) Kahlmeter, G An international survey of the antimicrobial susceptibility of pathogens from uncomplicated urinary tract infection: ECO SENS Project. J. Antimicrob. Chemother. 51: ) Zhanel, G., T. Hisanaga, N. Laing, et al Antibiotic resistance in Escherichia coli outpatient urinary isolates: Final results from the North American Urinary Tract Infection Collaboretive Alliance (NAUTICA). Int. J. of Antimicrob. Agents 27: ) : Vol. 18 No
6 226 The Analysis of Levofloxacin-resistant Esherichia coli Isolated from the Patients of Urinary Tract Infections and Their Background Factors Ken-ichi Ogura, Fuyuhiko Saito, Akira Turuoka, Ikuo Saito Department of Clinical Laboratory, Tama-Nambu Chiiki Hospital The objective of this study is to investigate the prevalence of levofluxacin (LVFX) resistant Escherichia coli, its drug-resistance pattern, and the background factors on resistant bacteria isolation for Escherichia coli isolated from urine specimens of the patients visited outpatient department of Urology, Tama-Nanbu Chiiki Hospital for 5 years from January 2001 to December As the regional medical support hospital for 5 cities in Tama region, this hospital is the secondary medical institute and mainly accepts referral patients by registered physicians. 125 strains of Escherichia coli out of total 811 testing specimens were isolated and 27 strains among them were found to be LVFX-resistant (MIC: 4 mg/ml) It was shown that resistant bacteria were gradually increased year by year and LVFX resistant bacteria, even in the community, were also increasing. The analysis of patients background factors statistically clarified that the patients with chronic diseases and the history of prior administration of quinolone drug had the tendency to be easily a#ected urinary tract infection due to LVFX resistant Escherichia coli. In conclusion, the microbiology laboratory at a general hospital assuming medical treatment for the specific region should always grasp the trend of bacterial resistance of oral antibiotics frequently used at the primary medical institute and give feedback those results as the infectious information. At the same time, we feel obligated to monitor and control the isolation status of resistant strains in the whole region. 6 Vol. 18 No
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