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Diagn Microbiol Infect Dis. 2008 Feb;60(2):177-83. Epub 2007 Oct 10.

Evaluation of antimicrobial susceptibility for beta-lactams using the Etest method against clinical isolates from 100 medical centers in Japan (2006).

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Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Faculty of Medicine, Tokyo 1438540, Japan.


This antimicrobial resistance surveillance study was performed in 100 medical centers. Susceptibility testing (Etest; AB BIODISK, Solna, Sweden) of 9152 strains including Escherichia coli (991 strains), Klebsiella spp. (1000 strains), Enterobacter spp. (971 strains), Citrobacter spp. (803 strains), indole-positive Proteae spp. (834 strains), Serratia spp. (902 strains), Acinetobacter spp. (874 strains), Pseudomonas aeruginosa (992 strains), oxacillin-susceptible Staphylococcus aureus (984 strains), and coagulase-negative staphylococci (CoNS; 801 strains) was performed with 7 beta-lactams (cefepime, cefpirome, ceftazidime, cefoperazone/sulbactam, imipenem and piperacillin for Gram-negative bacteria, or oxacillin for Gram-positive bacteria). No strain resistance to these beta-lactams (except for ceftazidime) was found in oxacillin-susceptible S. aureus and CoNS. Of the E. coli clinical isolates, 17.1% were resistant to piperacillin, whereas 2.9% or less (cefpirome = 2.9%) were resistant to other beta-lactam agents. Klebsiella spp. strains were more susceptible to imipenem (99.9%), cefepime (99.2%), ceftazidime (98.6%), and cefpirome (98.3%). Isolates of Enterobacter spp., Citrobacter spp., indole-positive Proteae, and Serratia spp. were susceptible to imipenem, cefepime, and cefpirome as well. Acinetobacter spp. strains were least resistant to cefoperazone/sulbactam (0.7% resistance), imipenem (2.6%), cefepime (6.6%), and ceftazidime (7.7%) compared with other beta-lactam antibiotics tested. Isolates of P. aeruginosa were more susceptible to ceftazidime (8.7% resistance), cefoperazone/sulbactam (9.8%), and cefepime (8.9%) than piperacillin (11.9%), cefpirome (16.2%), and imipenem (12.4%). The percentage of imipenem-resistant P. aeruginosa was approximately 13% in clinical isolates in Japan. The proportion of strains resistant to beta-lactam antimicrobials has been decreasing compared with data from 2004, suggesting that reduced consumption of beta-lactams has reflected the decreased rates of resistant bacterial isolates in Japan.

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