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Volume 57, Issue 1
Displaying 1-7 of 7 articles from this issue
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2004 Volume 57 Issue 1 Pages 1-10
Published: February 25, 2004
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSDownload PDF (18049K) -
NAGAO SHINAGAWA2004 Volume 57 Issue 1 Pages 11-32
Published: February 25, 2004
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSAntimicrobial prophylaxis is widely performed in any surgical proceduresto prevent postoperative infections. However, we have neither double-blind placebo-controlled studies nor sufficient surveillance of postoperative infections that are common in Europe and the United States, and therefore there is little convincing scientific basis accounting for the validity of this therapy. In addition, prophylactic agent is still uncovered by medical insurance despite the persistent arguments as to its necessity. To establish the guidelines in our own country, a greater deal of evidence needs to be accumulated. Strategies for antimicrobial prophylaxis should be determined based on the types of possible postoperative infections and the classifications of operations according to contamination levels in individual operative fields. This process may involve the precise selection of prophylactic agents for suspected contaminating bacterial species in each operative organ and their administrationregimens suitable for the individual surgery. Upon selection of prophylactic agents for postoperative infections, various conditions should be considered: e.g., susceptibility, resistance, blood concentrations, urinary excretion, transition into body fluid and tissues, and adverse reactions. The first and second generations of cephem and cephamycin derivatives can be the first choice, but the use of various other antibacterial agents may be necessary for resistant bacterial strains such as methicillin-resistant Staphylococcus aureus (MRSA) and penicillin-resistant Streptococcus pneumoniae (PRSP). Cyclic therapy based on penicillins (including mixtures), cephems (including cephamycins) and fosfomycins also seems useful for such resistant strains. At present, there is only limited evidence supporting the importance of prophylactic agents. Controlled trials employing well-designed protocols that endure scientific criticism must be done with due consideration for medical economics.View full abstractDownload PDF (2489K) -
SPECIAL REFERENCES TO BACTERIA ISOLATED BETWEEN APRIL 2002 AND MARCH 2003NAGAO SHINAGAWA, KOICHI HIRATA, TADASHI KATSURAMAKI, MITSUHIRO MUKAIYA ...2004 Volume 57 Issue 1 Pages 33-69
Published: February 25, 2004
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSTendency of isolated bacteria from infections in general surgery during the periodfrom April 2002 to March 2003 were investigated in a multicenter study in Japan, and the following results were obtained.
In this series, 334 strains were isolated from 131 (75.3%) of 174 patients with surgical infections. One hundred and seventy-one strains were isolated from primary infections, and 163 strains were isolated from postoperative infections. From primary infections, anaerobic Gram-positive bacteria were predominant, while aerobic Gram-positive bacteria were predominant from postoperative infections. Among aerobic Gram-positive bacteria, although the isolation rate of Staphylococcus aureus was the highest, followed by that of Enterococcus faecalis from primary infections, the isolation rate of E. faecalis was the highest from postoperative infections. Among anaerobic Gram-positiveb acteria, t he isolationr ate of Peptostreptococcus spp.was the highest fromb oth types of infections. Among aerobic Gram-negative bacteria, Escherichia coli was the most predominantly isolated from primary infections, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa in this order, and from postoperative infections, E. coli was the most predominantly isolated, followed by P.aeruginosa, Enterobacter cloacae, and Citobacter freundii. Among anaerobic Gram-negative bacteria, the isolation rate of Bacteroides fragilis group was the highest from both types of infections. The isolation rate of aerobic Gram-negative bacteria from primary infections and that of aerobic Gram-positive bacteria from postoperative infections were high in the last several years. We noticedn o vancomycin-resistanGt ram-positivec occi nor P. aeruginosa producingm etallo-β-lactamase. But we noticedc efazolin-resistant E. coli probablyp roducing extendeds pectrum β-lactamase.View full abstractDownload PDF (13466K) -
KEIZO YAMAGUCHI, YOSHIKAZU ISHIII, MORIHIRO IWATA, NAOKI WATANABE, NOB ...2004 Volume 57 Issue 1 Pages 70-104
Published: February 25, 2004
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSThe antibacterial activity of meropenem (MEPM) and other parenteral antibiotics against clinical isolates of 899 strains of Gram-positive bacteria, 1500 strains of Gram-negative bacteria, and 158 strains of anaerobic bacteria obtained from 28 medical institutions during 2002 was measured. The results were as follows;
1. MEPM was more active than other carbapenem antibiotics against Gram-negative bacteria, especially against enterobacteriaceae and Haemophilus influenzae. MIC90 of MEPM against Pseudomonas aeruginosa was the lowest of the drugs tested. MEPM showed low cross-resistant rate against both imipenem-resistant P. aeruginosa and ciprofloxacin-resistant P. aeruginosa. MEPM was active against most of the species tested in Gram-positive and anaerobic bacteria, except for multi-drug resistant strains including methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant Staphylococcus epidermidis (MRSE).
2. The proportion of extended-spectrum β-lactamase (ESBL) strains was 3.1% (4 strains) in Escherichia coli and 1.9% (2 strains) in Klebsiella pneumoniae. Carbapenems including MEPM were active against these ESBL strains.
In conclusion, the results from this surveillance study suggest that MEPM retains its potent and broad antibacterial activity and therefore is a clinically useful carbapenem at present, 7 years after available for commercial use.View full abstractDownload PDF (10558K) -
AKIRA IWASHIMA, KAZUHIRO SATO, TOSHIRO KIGUCHI, MISAKO YAMAGUCHI2004 Volume 57 Issue 1 Pages 105-117
Published: February 25, 2004
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSWe measured MICs of various antimicrobial agents against Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa isolated in the Nagaoka district of Niigata Prefecture in 2000 (March-May), 2001 (January-May), and 2002 (March-May).
S. pneumoniae: Fifty-six strains were isolated in 2000, 119 strains in 2001, and 88 strains in 2002. In 2000, 2001, and 2002, 24 strains (42.9%), 58 strains (48.7%), and 40 strains (45.5%), respectively, were penicillinintermediate S. pneumoniae (PISP), and 4 strains (7.1%), 12 strains (10.1%), and 7 strains (8.0%), respectively, were penicillin-resistant S. pneumoniae (PRSP). Carbapenems had the most excellent antimicrobial activity, followed by penicillin G, against penicillin-susceptible S. pneumoniae (PSSP), PISP, and PRSP.
H. influenzae: Seventy-six strains were isolated in 2000, 154 strains in 2001, and 91 strains in 2002. In 2000, 2001, and 2002, 6 strains (7.9%), 8 strains (5.2%), and 7 strains (7.7%), respectively, were ? A-lactamaseproducing ampicillin (ABPC)-resistant strains (MIC-≥2, μg/ml), showing no increase, and 14 strains (18.4%), 70 strains (45.5%), and 31 strains (34.1%), respectively, were β-lactamase-non-producing ABPC-resistant strains (MIC≥2μg/ml), showing a slight increase. Ceftriaxon, meropenem (MEPM), and levofloxacin had excellent antimicrobial activity against these resistant strains.
P aeruginosa: In 2000, 2001, and 2002, 135, 74, and 91 strains, respectively, were isolated, and 14 strains (10.4%), 17 strains (23.0%), and 24 strains (26.4%), respectively, were imipenem-resistant (MIC.≥16μg/ml), showing a slight increase. MEPM, biapenem, and ciprofloxacin had excellent antimicrobial activity against P.aeruginosa.View full abstractDownload PDF (1297K) -
HIROSHI TANIMURA, HIRONOBU OHNISHI2004 Volume 57 Issue 1 Pages 118-123
Published: February 25, 2004
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSClinicapl harmacologisctauldies of a novefl luoroquinoloanneti bacteridarlug, cadrofloxacwine, reperformed in 12 surgical patients by investigating the transfer of cadrofloxacin into the gallbladder tissue and bile. They were scheduled for cholecystectomy (n=6) or had undergone a percutaneous transhepatic biliary drainage (n=5) or gallbladder drainage (n=1) at the Second Department of Surgery, Wakayama Medical University. A single dose of cadrofloxacin was orally administered to all patients at a dose of 200 mg. The results were as follows:
1) Serum and gallbladder tissue levels of cadrofloxacin after 2.9-5.7 hours were 0.6-2.5μg/ml and 0.6-8.6μg/ml, respectively. The gallbladder/serum ratios of drug concentration were 0.6-3.4
2) Levels of cadrofloxacin in bile reached a peak of 2.5-12.9μg/ml after individually different period of time. Cumulative bile recoverlies of cadrofloxacin (unchanged compound+glucuronide conjugate) within the first 6 hours were 0.02-0.49%, and 0.08-0.75% within 0-12 hours. The mean value of [glucuronide conjugate/unchanged compound] in bile was 37%, although the values depended on the patients.View full abstractDownload PDF (626K) -
F. YAMAMOTO, S. HARADA, T. MITSUYAMA, Y. HARADA, Y. KITAHARA, M. YOSHI ...2004 Volume 57 Issue 1 Pages 124-133
Published: February 25, 2004
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSClarithromycin (CAM) and rifampicin (RFP) have both been recognized to be effective antibiotic agents against Mycobacterium avium complex (MAC) infection. Rifamycin derivatives including RFP and rifabutin modulate the CAM metabolism by inducing the hepatic cytochrome p-450 3A4. To clarify the effect of RFP on the CAM metabolism, we measured the plasma concentration of CAM and 14-R-hydroxyclarithromycin (M-5), the major metabolite of CAM, in 9 patients suffering from MAC infection before and after the addition of RFP. After the addition of RFP, the mean plasma concentration of CAM significantly decreased, while that of M-5 did not. In addition, the amount of CAM+M-5 concentration also significantly decreased. As M-5 is less effective against MAC infection than CAM, more attention should thus be paid to the plasma CAM concentration in patients administered CAM and RFP concomitantly.View full abstractDownload PDF (968K)
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