薬理と治療

Abstract

Antibiograms are an important source of information for initiating empirical antibiotic therapy of infectious diseases. Hospital-wide antibiograms may not sufficiently support the decision-making process for performing the optimal treatment against infection in hospitalized patients. In this study, we investigated the antimicrobial susceptibility rates（SRs）of Escherichia coli and Pseudomonas aeruginosa at various detection sites and from different hospital wards which were collected from inpatients between April 2013 and March 2016 at Fukuoka University Chikushi Hospital. The first isolate collected from each detection site （blood, respiratory tract, gastrointestinal tract, urinary tract and other）for each patient was used. In the E. coli isolates, the SRs of nine antibiotics showed significant differences among detection sites, and most of them were low in respiratory tract and high in gastrointestinal tract. In the P. aeruginosa isolates, isolates from intensive care units showed significantly lower SRs of aztreonam, imipenem, and meropenem than the isolates obtained from general wards（48.8％ vs. 69.6％, P＜0.01；67.1％ vs. 82.2％, P＜0.05；and 72.0％ vs. 94.1％, P＜0.001, respectively）. In addition, isolates from blood and respiratory tract specimens showed significantly lower SRs of meropenem in intensive care units in comparison to the same isolates obtained from general wards（55.6％ vs. 100％, P＜0.05 and 73.6％ vs. 90.9％, P＜0.05, respectively）. We thus found that the SRs of several antibiotics differed depending on the detection site and the type of hospital ward, and this information may therefore be useful for performing optimal empiric therapy in the clinical setting.