Use of Carbapenems and Antibacterial Susceptibility of Clinical Isolates of Pseudomonas aeruginosa

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  • TOCHIKURA Naohiro
    Department of Pharmacy, Nihon University, School of Medicine, Nerima Hikarigaoka Hospital
  • KABURAGI Morio
    Department of Pharmacy, Nihon University, School of Medicine, Nerima Hikarigaoka Hospital
  • YAMADATE Syuukou
    Department of Clinical Laboratory, Nihon University, School of Medicine, Nerima Hikarigaoka Hospital
  • MOTOISHI Hiroyuki
    Department of Pharmacy, Soka Citizen Hospital
  • HAYASHI Kuniki
    Department of Clinical Laboratory, Nihon University, School of Medicine, Nerima Hikarigaoka Hospital Presently Surgery and Gastroenterology, Nagayama Clinic

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Other Title
  • カルバペネム系抗菌薬の使用と緑膿菌の薬剤耐性
  • カルバペネムケイ コウキンヤク ノ シヨウ ト リョクノウキン ノ ヤクザイ タイセイ

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We investigated the use of carbapenems in our hospital between January 2005 and June 2008, and examined the trend of susceptibility to different antibacterial agents and cross-resistance using 813 strains of Pseudomonas aeruginosa isolated from in-patients. We conducted susceptibility tests to carbapenems on 38 strains isolated during a three-month period from November 2007, for comparison with the findings of nationwide surveillance. The amount of carbapenems used markedly increased by approximately 2 times in July-December 2007 (later half) compared to January-June 2007 (first half). From 2005 to 2007, annual changes in susceptibility were low, and the susceptibility rates were maintained at 90% or above for AMK, GM, CPFX, LVFX, PIPC and CFPM; and at 80% or above for IPM and MEPM. In 2008, the number of antibiotics with susceptibility rates of 90% or above was reduced to only three: AMK, GM and PIPC. These results suggested that increased use of carbapenems was related to decreases in susceptible bacteria. Comparison of the susceptibility rates to different antibacterial agents of 35 IPM-resistant strains and 27 MEPM-resistant strains isolated during a one-year period from July 2007 found that the susceptibility rates were low in MEPM-resistant strains. Comparison of the susceptibility results of strains isolated from November 2007 to January 2008 with the nationwaide surveillance data found that the MEPM-resistant rate was higher at 23.7%. Comparison of the resistance rates to carbapenems showed that the resistance rate to DRPM was the lowest at 22-33%. No metallo-beta-lactamase-producing and no multi-drug resistant P. aeruginosa strains were observed. Although the present study period was only for a short period of 3.5 years, the results indicated that increased use of carbapenems is associated with decreases in susceptibility rates; in particular MEPM-resistant strains showed decreased susceptibility to various antibacterial agents including carbapenems. In the future, survey of the trends of carbapenem use and surveillance of bacterial susceptibility should be continued to ensure correct use of carbapenems.<br>

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