The surveillance study was conducted to determine the antimicrobial activity of fluoroquinolones (ofloxacin, levofloxacin, ciprofloxacin, tosufloxacin) and other 20 antimicrobial agents against 5,180 clinical isolates obtained from 26 medical institutions during 1998 in Japan.
The resistance to fluoroquinolones was remarkable in Enterococci, methicillin-resistant stapylococci and Pseudomonas aeruginosa from UTI. However, many of the common pathogens such as Streptococcus pneumoniae including penicillin-resistant isolates, methicillin-susceptible Stahylococcus aureus, Moraxella catarrhalis, the family of Enterobacteriaceae, Haemophilus influenzae including ampicillin-resistant isolates have been kept to be susceptible to fluoroquinolones. About 90% of P. aeruginosa isolates from RTI were susceptible to fluoroquinolones.
In conclusion, the results from this surveillance study suggest that fluoroquinolones are useful in the treatment of various bacterial infections including respiratory infections.

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To evaluate the resistance for major oral antimicrobial agents, mainly new quinolones, we carried out a drug susceptibility surveillance of 3,050 strains of 11 microbial species clinically isolated at 8 institutions such as general hospitals and examination centers in Hiroshima city. 10 antimicrobial agents were used: 3 new quinolone drugs, 5β-lactam drugs, minocycline and clarithromycin.
Among Gram-positive bacteria, methicillin resistant Staphylococcus aureus (MRSA) and Enterococcus faecalis showed low susceptibility to the new quinolone drugs, while methicillin susceptible Staphylococcus aureus (MSSA) and Streptococcus pneumoniae were highly sensitive to these drugs. Among Gram-negative bacteria, Pseudomonas aeruginosa showed high resistance for the new quinolone drugs, but enteric bacteria and Haemophilus influenzae did not show marked resistance, maintaining almost good sensitivity to these drugs.
To reduce the appearance of resistant bacteria, appropriate antimicrobial agents should be selected. Drug susceptibility surveillance in the community will be also important in the future.

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We examined colony PCR that does not use the prepared template DNA but intact cells as the template DNA source for the rapid, simple and reproducible detection of antibiotic resistance genes in strains of methicillinresistant Staphylococcus aureus (MRSA) and Enterococcus.Two factors turned out to be important; i.e. the transfer size of bacterial cells and the use of DNA Polymerase with high performance. In practice, the tip of a toothpick was lightly touched with a colony on agar plates followed by the PCR mixture (20μl) containing KOD-plus-DNA Polymerase and multiplex primers. The cell transfer size ranged from 10³to 10⁴cfu and 30 cycles of PCR (95°C, 30sec.→50→C, 30sec.→72°C, 60sec.) following the first heating (95→, 3min.) resulted in good amplification of the target regions of mecA and aac (6′) /aph (2″) that are responsible for the resistance to methicillin and arbekacin, respectively.

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Aiming at evaluating the utility of cefozopran (CZOP) against complicated urinary tract infections with the velocity of eradication of causal bacteria in early treatment and clinical efficacy by new criteria of UTIs, a comparative study was conducted using cefpirome (CPR) as the control drug. CZOP and CPR were administered by intravenous drip infusion at a dose of 1g twice daily. The duration of treatment was for 5 days. The study method involved randomized assignment of the subjects to either group CZOP or group CPR.
The results were as follows:
1. Of a total of 80 cases treated, 65 (CZOP group-32 cases, CPR group-33 cases) were evaluated for efficacy.
2. The overall clinical efficacy evaluation according to the criteria proposed by Japanese UTI Committee rated the CZOP group as 90.6% (29/32), and the CPR group as 90.9% (30/33), with no significant difference between the 2groups. Clinical efficacy evaluated by attending physicians rated the CZOP group as 93.8% (30/ 32) and the CPR group as 90.9% (30/33). There was no significant difference between the 2 groups.
3. The efficacy rates to pyuria on day 2 were 26.7% and 0% for the CZOP group and the CPR group, respectively, indicating a higher efficacy rate for the former (p<0.05). Those on after treatment were 59.4% and 54.5% for the CZOP group and the CPR group, respectively, with no significant difference between the 2 groups.
4. Regarding the bacteriological effect, the eradication rates of both groups were over 90% on day 1 and after treatment. There was no significant difference between the 2 groups.
5. Side effects occurred in 1 case (2.6%) out of 39 in the CZOP group and in 1 case (2.4%) out of 41 in the CPR group. Laboratory test value fluctuation was noted in 8 (20.5%) of 39 cases in the CZOP group and 11 (26.8%) of 41 cases in the CPR group. There was no significant difference between the 2 groups.
The results indicate that CZOP achieves an early efficacy to pyuria, and is as useful as CPR against compli-cated urinary tract infections.

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