Isolated bacteria from infections in general surgery during the period from July 1994 to June 1995 were investigated in a multicenter study in Japan, and the following results were obtained.
One hundred and sixty-four strains were isolated from primary infections, and 202 strains were isolated from postoperative infections. From primary infections, anaerobic Gram-positive bacteria were predominant, while from post operative infections, aerobic Gram-positive bacteria were predominant. Among aerobic Gram-positive bacteria, the isolation rate of Enterococcus faecalis was the highest, followed by that of Staphylococcus aureus from postoperative infections. Among anaerobic Gram-positive bacteria, the isolation rate of Peptostreptococcus spp. was the highest from both types of infections. Among aerobic Gram-negative bacteria, Escherichia coli was the most predominantly isolated from primary infections, fllowed by Klebsiellap neumoniae and Pseudomonas aemginosain this order, and from postoperative infections, P. aeruginosa was the most predominantly isolated, followed by Entembacter spp. and Klebsiella spp. Among anaerobic Gram-negative bacteria, the isolation rate of Bacteroides fragilis group was the highest from both types of infbctions.
We noticed that MICs of cefazolin against three out of 23 strains of E. coli were higher than 100μg/ml. Among anaerobic bacteria, there were many resistant strains against penicillins and cephems with MICs higher than100μg/ml, and the same trend was observed among other Bacteroides spp.and Prevotella spp.

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This study was conducted to investigate susceptibilities of clinical isolates to imipenem (IPM) and other antibacterial agents in 144 hospital laboratories throughout Japan from September to December of 1992. In this study, the isolates were identified and susceptibility tests were performed at individual laboratories. The susceptibility tests were performed using the disk dilution method recommended by NCCLS.
S. aureus (including MRSA) strains were highly susceptible to arbekacin (ABK) and netilmicin (NTL). S. pneumoniae and H. influenzae were susceptible to most of the agents tested. E. faecaliswere highly susceptible to penicillins and imipenem (IPM). P.aeruginosa showed high susceptibility to ceftazidime (CAZ), IPM and amikacin (AMK).
Annual changes in antimicrobial susceptibility patterns over 5 years (1988-1992) were examined. The frequency of sensitive strains of S. aureus to methicillin (DMPPC) has slightly increased from 1991 to 1992. A moderate increases of PCG-insensitive S. pneumoniae was observed. B. fragilis group showed a slight increase in sensitivity to minocycline (MINO) but no yearly changes in IPM sensitivity was observed.

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Between January, 1982 and December, 1994, 236 Pseudomonas aeruginosa strains were isolated from clinical specimens at our division, and were tested for serotypes and drug-susceptibilities to 15 antibiotics. Serotype G strains were isolated at the highest frequency (32.6%), and followed by strains of serotype B (15.7%), A (11.9%), E (9.3%), I (7.2%), F and M (5.5%), non-typable (5.1%), D (3.4%), H (2.1%), C and K (0.8%).
We examined the changes of isolation frequencies of different serotypes annually. Isolation frequencies of serotypes E and F showed tendency to decrease, whereas serotype I has been isolated increasingly year by year.
MIC_90's of the 15 antibiotics were as follows, tosufloxacin: 0.78μg/ml, biapenem (BIPM) and ofloxacin (OFLX): 3.13 μg/ml, imipenem (IPM), ceftazidime, cefozopran, cefsulodin and gentamicin: 6.25 μg/ml, aztreonam and amikacin: 12.5μg/ml, piperacillin, cefoperazone and minocycline (MINO): 25μg/ml, fosfomycin: 100μg/ml and chloramphenicol:>200,μg/ml.
MIC_90's of IPM, BIPM, MINO and OFLX increased 4-fold from stage I (1982-1987) through stage III (1992-1994) and the isolation frequency of drug-resistant strains increased year by year. In other words, antibiotic resistant strains appeared increasing with time.
No relationship between serotypes and drug-resistance were observ ed.

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In vitro antifungal activities of rilopirox (RIL), a new topical hydroxypyridone antifungal agent, were studied against 7 species (31 strains) of yeast-like fungi and 15 species (17 strains) of mycerial fungi from stock cultures of a wide range of medically important fungi. Tests were carried out by the liquid dilution method using Neopeptone dextrose broth with ciclopirox olamine (CPO) and oxiconazole nitrate (OCZ) as reference drugs. RIL exhibited a broad spectrum of antifungal activities; the MIC_s of RIL against yeasts were about 1μg/ml, those against other fungi were 0.5- 4μg/ml. Antifungal activities were similar to CPO, and compare to OCZ, RIL showed characteristically little differences in its activities against different species or strains of target organisms.

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Azithromycin (AZM) in fine granules was studied for its phamacokinetics and clinical efficacies in eight child patients with ages between 1 month and 8 years. Informed consent was received from all of their parents. AZM was administered to the patients once a day at a dose of 10 mg/kg for 3 days.
The clinical efficacies of AZM in 8 patients with microbial infections (pneumonia in one, Mycoplasma pneumonia in two, acute tonsillitis in one, pertussis in one, Campylobacter enteritis in one, infectious enteritis in one, Salmonella enteritis in one) were evaluated as “excellent” in five cases, “good” in two and “not evaluable” in one. As for the microbial efficacy, isolated strains were eradicated in 2 out of 3 patients.
No adverse reaction was found except for one case with abnormal laboratory change, that is mildly increased GPT value.
Plasma samples were collected from 3 cases. The elimination half-life of AZM was 45.8 hours. AUC_-∞was 12.6 μg hr/ml. Urine sample was collected from one. AZM concentration in urine was 35.0μg/ml during a period between 48 and 72 hours after the start of treatment.

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35 children between 9 months and 12 years of ages were gi ven 9.1 to 12.2 mg/kg of azithromycin (AZM) once a day for 3 days. In the treatment of pediatric infectious diseases, we studied pharmacokinetics, efficacy and safetiness of AZM. After administration of 10 mg/kg/day of AZM for 3 days, the elimination half-life was calculated to be 38.2±1 16.3 hours (n= 6, mean±S. D.). The excretion rate of AZM in the urine within 120 hours of administration was 9.0±2.3% (n= 5). For the evaluation of efficacy of AZM, we treated 33 cases of children with pharyngotonsillitis, bronchitis, mycoplasma bronchitis, pneumonia, mycoplasma pneumonia, atypical pneumonia, and SSTI. The efficacy rate of these cases were 93.9%. 6 strains of bacteria were identified as causative agents. All strains were eradicated upon the treatment. One case of elevated GOT and GPT and two cases of elevated GPT were observed. No clinical adverse reactions were observed.
In conclusion, AZM was useful for the treatment of pediatric infectious diseases we examined.

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