The Japanese Journal of Antibiotics
Online ISSN : 2186-5477
Print ISSN : 0368-2781
ISSN-L : 0368-2781
Volume 75, Issue 3
Displaying 1-2 of 2 articles from this issue
Original Article
  • Maiko Ueda, Tetsuro Muratani, Haruhisa Saku
    2023 Volume 75 Issue 3 Pages 45-54
    Published: September 25, 2023
    Released on J-STAGE: June 13, 2024

    There are some reports of nosocomial infections caused by vancomycin-resistant enterococci (VRE) in Japan, and it is an antimicrobial resistant bacterium that needs to be detected and prevention of outbreak at an early stage. As a screening method for VRE carriers, it is very inefficient to isolate and identify enterococci from clinical specimens, especially feces, and to perform antimicrobial susceptibility test. In such cases, the use of VRE selective media is a useful method. This time, we had the opportunity to evaluate “CHROMagar™ VRE blue (CHROMagar)”(CH-blue), a new VRE selective medium already in use in the United States. To evaluate the performance of CH-blue, VRE detect test were performed using “CHROMagar™ VRE (CHROMagar)”(CH-VRE) and “BD BBL™ VRE selective medium (Becton Dickinson and company)”(BD-VRE), as controls. A total of 267 strains were used, including 153 enterococcal strains having vanA, vanB, and vanD, and 114 wild type enterococcal strains including 25 strains of Enterococcus gallinarum and 25 strains of Enterococcus casseliflavus that do not have vanA, vanB, and vanD. The growth of these strains was evaluated using four types of media, blood agar medium, CH-VRE, CH-blue, and BD-VRE, according to the Misra’s method. Sensitivity was defined as whether enterococcal strains carrying the exogenous vancomycin resistance factors as vanA, vanB, and vanD could be detected, and specificity was defined as not detecting strains without exogenous vancomycin resistance factors including vanC carrying strains. At 108 cfu/spot, sensitivity was over 97% for all three media, and at 106 cfu/spot, sensitivity was over 93%. At 103 cfu/spot, the sensitivity was slightly lower, but it was 82.4–85.0%. The specificity was 100% for CH-blue even at 106 cfu/spot, superior to 83.3% for CH-VRE and 99.1% for BD-VRE. At 103 cfu/spot, specificity was 100% for VRE blue and BD-VRE, but 92.1% for CH-VRE. CH-VRE blue, which is already in use in Europe and the United States, was clearly superior to the currently used CH-blue in inhibiting the development of VanC type. For VanB type E. faecium, which has a low MIC in vancomycin, detection sensitivity of CH-blue at 106 cfu/spot was inferior to CH-VRE but comparable at 108 cfu/spot. It is considered that CH-blue is an excellent VRE selective medium with performance equivalent to that of BD-VRE.

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Research Report
  • Takahiro Amemiya, Hiroshi Suzuki
    2023 Volume 75 Issue 3 Pages 55-61
    Published: September 25, 2023
    Released on J-STAGE: June 13, 2024

    Tazobactam/piperacillin (TAZ/PIPC) is considered as a key drug in the treatment of ventilator-associated pneumonia and other infectious diseases in acute care units. However, The high frequency of TAZ/PIPC-induced drug-induced liver injury (DILI) is a clinical problem. This study aimed to identify the risk factors for DILI induced by TAZ/PIPC in the pre-dose phase. Patients treated with TAZ/PIPC were retrospectively selected. Univariate analysis and Multivariate logistic regression analysis between patients with DILI and those without DILI (non-DILI) were performed for age, gender, dose, duration of administration and clinical laboratory values immediately before the start of administration of Albumin (Alb), Blood urea nitrogen (BUN), Creatinine (Cre), Sodium (Na), Potassium (K), Chloride (Cl), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Total Bilirubin (TBil), Lactate dehydrogenase (LDH), C-reactive protein (CRP), White blood cell (WBC), Red blood cell (RBC), Hemoglobin (Hb), Hematocrit (Hct) and Platelet (PLT). As a result, High CRP and RBC levels before the administration of TAZ/PIPC in men were considered to be risk factors for the development of DILI. Consideration of the possibility of treatment with other antimicrobials or closer monitoring of liver function tests in patients receiving TAZ/PIPC with these risk factors may help prevent the development and severity of DILI.

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