Comparative studies of antimicrobial agents against causative organisms isolated from urinary tract infections (1984): I. Susceptibility distribution

Nozomu Kosakai, Yoshiaki Kumamoto, Shigeru Sakai, Takaoki Hirose, Shiro Shigeta, Yasuo Shiraiwa, Yutaka Miura, Masahiro Ogata, Hiroshi Tazaki, Hisami Iri, Hiroshi Uchida, Yasuhiko Ando, Hiroshi Furuya, Seiji Matsuda, Noboru Soeda, Mamoru Yokomatsu, Ryuichi Kitagawa, Yoshinao Hikichi, Naofumi Miyazaki, Yasuyuki HayashiToyoko Oguri, Taro Furusawa, Yasuko Takeuchi, Hiromi Tsuchida, Nobuyuki Yamashita, Yuruko Okamoto, Seibun Yonezu, Keigo Maehara, Yube Iida, Shoji Shimoe, Michio Tanaka, Keizo Yamaguchi, Nobuchika Kusano, Jun Igari

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Abstract

Our research group was engaged for 3 years (1979–1981) in a study on sensitivities to antibiotics of 4 bacterial groups including representative pathogenic bacteria found in cases of urinary tract infections; i.e. E. coli, Klebsiella spp., Citrobacter spp., and Proteus spp. Since 1982, all the bacterial strains isolated by our group from patients with urinary tract infections and deemed by doctors in charge as pathogens were sent to the Laboratory of Clinical Pathology of Juntendo University, where they were refixed and subjected to MIC determination. This is the third year of the new study. E. coli was detected most frequently from patients with urinary tract infections and the detection frequency was 28% (323/1,153) this year (1984), whereas it was 35.3% (304/860) last year, showing a 7% decline from last year to this year. E. faecalis was next frequent organism (12.7% or 147/1,153) followed by P. aeruginosa (10.8% or 124/1,153). This order, however, was reversed from last year. Other pathogens, in a decreasing order of isolation frequencies following the above three, were as follows: Proteus spp. (9.5% or 109/1,153), S. marcescens (6.2% or 71/1,153), S. epidermidis (5.4% or 62/1,153), K. pneumoniae (4.9% or 56/1,153), Enterobacter spp. (2.4% or 28/1,153) and Citrobacter spp. (2.3% or 27/1,153). The results of the determination of the sensitivity of bacterial strains to the antibiotics are described below. 1. Of all the oral antibacterial and antibiotic agents used against E. coli, mecillinam (MPC), cefaclor (CCL) and pipemidic acid (PPA) proved to have high antibacterial potency, and their MIC90 (the concentration to inhibit growths of 90% of the objective bacteria) was 3.13 µg/ml. The MIC90's of cefotiam (CTM), cefotaxime (CTX), ceftizoxime (CZX), cefmenoxime (CMX) and latamoxef (LMOX) were less than 0.39 µg/ml. The MIC90's of cefmetazole (CMZ) and cefoperazone (CPZ) were invariably 1.56 µg/ml. 2. K. pneumoniae was not sensitive to ampicillin (ABPC) and did not show much sensitivity to other oral antibacterial and antibiotic agents also. Of all the injectable preparations of antibiotics, cephem antibiotics of the third generation showed the most potent antibacterial effects against K. pneumoniae, and their MIC90's were lower than 0.10 µg/ml for CZX, 0.20 µg/ml for CTX, 0.39 µg/ml for CMX, and 0.78 µg/ml for LMOX, while MIC90's of CPZ was 6.25 µg/ml, which was equal to that of CMZ. The MIC90 of CTM was 0.78 µg/ml which was identical to that of LMOX. 3. The sensitivity of Citrobacter spp. to the objective antibacterial and antibiotic agents was low, but showed some sensitivity to MPC, nalidixic acid (NA), PPA and sulfamethoxazole-trimethoprim (ST). Of all the injectable antibiotics, LMOX and CMX were the most effective against Citrobacter spp., showing MIC80 of 6.25 µg/ml and 12.5 jug/ml, respectively. 4. Fairly strong antibacterial activity was shown by MPC to Enterobacter spp. and its MIC80 was 12.5 µg/ml. The Enterobacter spp. showed low sensitivity to the injectable preparations of cephem antibiotics of the first and the second generations except for CTM, and the MIC80 was invariably higher than 200 µg/ml. The MIC80 of CTM was 6.25 µg/ml. The MIC80's of the cephem antibiotics were 12.5 µg/ml for CMX, 25 µg/ml for both LMOX and CTX, and 50 µg/ml for both CZX and CPZ. 5. P. mirabilis was very sensitive to cephem antibiotics of the third generation. The MIC90's of CZX, CTX and CMX were lower than 0.10 µg/ml, while that of LMOX was 0.20 µg/ml. 6. P. vulgaris was less sensitive to cefazolin (CEZ) and CTM than to cefoxitin (CFX) or CMZ. The MIC90's of the cephem-derived antibiotics such as CMX, CTX and CZX excepting CPZ were less than 0.10 µg/ml, while that of LMOX was 0.20 µg/ml. 7. M. morganii was proved to be inhibited strongly by the cephem antibiotics of the third generation. The MIC80's of CZX and LMOX were invariably 0.39 µg/ml, while those of CTX and CMX were 0.78 µg/ml and 1.56 µg/ml, respectively. The MIC80 of CPZ was 6.25 µg/ml. 8. P. aeruginosa showed fairly high sensitivity to gentamicin (GM), amikacin (AMK), tobramycin (TOB), dibekacin (DKB), cefsulodin (CFS), piperacillin (PIPC), sisomicin (SISO) and CPZ, and the MIC50's of these agents were in the range of 1.56–6.25 µg/ml. 9. Serratia spp. was not inhibited by oral antibiotic agents or by cephem antibiotics of the first and the second generations. It showed some sensitivity only to the cephem antibiotics of the third generation, and the MIC80's of CZX and CMX were identical at 6.25 µg/ml. The sensitivity of representative bacteria isolated from cases with urinary tract infections to injectable preparations of cephem antibiotics of the third generation will be discussed below as was previously done for 1983. The cephem antibiotics of the third generation were clinically used in a limited number of institutions and hospitals in 1976–1980. The antibacterial effects of these antibiotics observed during these years were respectively reported in special issues of Chemotherapy. The results of these clinical applications and the results of our uses during the period since 1981 up to 1984 were comparatively evaluated in terms of MIC80 and MIC90. Table 18 showed the MIC80's of cephem antibiotics of the third generation against E. coli. A comparison of the results with those during the period from 1976 to 1978 showed no specific tendency of decline of the antibacterial effect. There was no tendency of decline in 1984 of the antibacterial effect of any of the agents except CPZ to Klebsiella spp. (Table 19). Effects of antibiotic agents against C. freundii in terms of MIC80 were also comparatively evaluated. Even cephem antibiotics of the third generation showed weak antibacterial effects and their MIC80's were over 25 µg/ml in the cases of CZX, CPZ and CTX, but both CMX and LMOX demonstrated relatively good antibacterial effects against C. freundii. (Table 20). Table 21 shows the MIC80's of the antibacterial and antibiotic agents to S. marcescens. Of all the cephem antibiotics of the third generation, CMX and CZX showed some antibacterial effects, whereas CPZ, LMOX and CTX did not show appreciably high antibacterial efficacy. There was no notable difference in the antibacterial efficacy of cephem antibiotics of the third generation against bacteria isolated from patients with urinary tract infections (Table 21). The results of the determination of the sensitivity of bacteria isolated from cases with urinary tract infections from 8 hospitals in Japan to various antibacterial and antibiotic agents and frequencies of their isolations were evaluated above. Variations of the sensitivity in respective years, backgrounds of the patients and their correlation to the sensitivity will be described in the following report.

Original languageEnglish
Pages (from-to)2959-3006
Number of pages48
JournalThe Japanese journal of antibiotics
Volume39
Issue number11
DOIs
Publication statusPublished - Nov 1986

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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    Kosakai, N., Kumamoto, Y., Sakai, S., Hirose, T., Shigeta, S., Shiraiwa, Y., Miura, Y., Ogata, M., Tazaki, H., Iri, H., Uchida, H., Ando, Y., Furuya, H., Matsuda, S., Soeda, N., Yokomatsu, M., Kitagawa, R., Hikichi, Y., Miyazaki, N., ... Igari, J. (1986). Comparative studies of antimicrobial agents against causative organisms isolated from urinary tract infections (1984): I. Susceptibility distribution. The Japanese journal of antibiotics, 39(11), 2959-3006. https://doi.org/10.11553/antibiotics1968b.39.2959