Current status of bacterial resistance in the otolaryngology field: Results from the Second Nationwide Survey in Japan.
Current status of bacterial resistance in the otolaryngology field: Results from the Second Nationwide Survey in Japan.
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DOI：
10.1007/s10156-002-0209-3
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发表时间：
2003-03-01
影响因子：
2.2
通讯作者：
Baba, Shunkichi
中科院分区：
文献类型：
--
作者：
Suzuki, Kenji;Nishimura, Tadao;Baba, Shunkichi
本文报道的研究是在1998年11月至1999年3月期间对中耳炎（466例急性化脓性中耳炎患者和476例慢性化脓性中耳炎患者）、鼻窦炎（447例急性鼻窦炎患者和426例慢性鼻窦炎患者）、急性扁桃体炎（724例患者）和扁桃体周围脓肿（141例患者）进行的全国性评估。80所大学医院、79所附属医院和103名全科医生参加了会议。耐甲氧西林金黄色葡萄球菌（MRSA）占786株分离株的15.6%。金黄色。MRSA在化脓性中耳炎患者中经常被检测到，但在急性扁桃体炎或扁桃体周围脓肿患者中并不常见，并且在已经接受治疗的患者中比未接受治疗的患者更常见，两组之间存在显著差异。万古霉素（VCM）对MRSA的抗菌活性最高，未发现耐药菌株。青霉素敏感的肺炎链球菌（PSSP），青霉素中间耐药的S。pneumoniae（PISP）和青霉素耐药S.肺炎链球菌（PRSP）分别占228株分离菌株的49.6%、28.5%和21.9%; pneumoniae，分别PISP和PRSP经常在5岁或5岁以下的儿童中发现。100株卡他莫拉菌中有96株（96%）产生β-内酰胺酶。281株流感嗜血杆菌中，β-内酰胺酶阴性、氨苄西林敏感（BLNASe）199株（70.8%），β-内酰胺酶阴性、氨苄西林耐药（BLNAR）65株（23.1%），产β-内酰胺酶17株（6.0%）。BLNAR菌株经常在预治疗患者中检出。281株H.流感病毒，214例有不可分型的胶囊。总之，主要的细菌物种显示出对β-内酰胺类抗生素的耐药性，这表明在选择适当的抗菌剂时应谨慎。
The study reported here was a nationwide assessment of otitis media (466 patients with acute suppurative otitis media and 476 with chronic suppurative otitis media), sinusitis (447 with acute sinusitis and 426 with chronic sinusitis), acute tonsillitis (724 patients), and peritonsillar abscess (141 patients) performed between November 1998 and March 1999. Eighty university hospitals, 79 affiliated hospitals, and 103 general practitioners participated. Methicillin-resistant Staphylococcus aureus (MRSA) comprised 15.6% of the 786 isolated strains of S. aureus. MRSA was frequently detected in patients with suppurative otitis media, but was uncommon in those with acute tonsillitis or peritonsillar abscess, and it was more common in those who had already been treated than in those who had not, with a significant difference between the groups. Vancomycin (VCM) showed the highest antimicrobial activity against MRSA and no VCM resistance was detected. Penicillin-sensitive Streptococcus pneumoniae (PSSP), penicillin-intermediate-resistant S. pneumoniae (PISP), and penicillin-resistant S. pneumoniae (PRSP) accounted for 49.6%, 28.5%, and 21.9% of the 228 isolated strains of S. pneumoniae, respectively. PISP and PRSP were frequently detected in children aged 5 years or younger. beta-Lactamase was produced by 96 of the 100 strains (96%) of Moraxella (Branhamella) catarrhalis. The 281 strains of Haemophilus influenzae isolated consisted of 199 beta-lactamase-negative, ampicillin-sensitive (BLNASe) strains (70.8%), 65 beta-lactamase-negative ampicillin-resistant (BLNAR) strains (23.1%), and 17 beta-lactamase-producing strains (6.0%). BLNAR strains were frequently detected in pretreated patients. Of these 281 strains of H. influenzae, 214 had nontypable capsules. In conclusion, the major bacterial species showed resistance to beta-lactams, indicating that care should be taken when selecting an appropriate antimicrobial agent.