Nationwide surveillance of antimicrobial susceptibility patterns of pathogens isolated from surgical site infections (SSI) in Japan

• DOI: 10.1007/s10156-012-0509-1
• Publication Date: 2012-11-09T16:15:17Z
• Authors: Yoshio Takesue; Akira Watanabe; Shinya Kusachi; Tetsuro Matsumoto; Aikichi Iwamoto; Kyoichi Totsuka; Keisuke Sunakawa; Morimasa Yagisawa; Junko Sato; Toyoko Oguri; Kunio Nakanishi; Yoshio Takesue; Yoshio Takesue; Hideaki Hanaki; Shinya Kusachi; Yoshinobu Sumiyama; Yuko Kitagawa; Yoshinobu Sumiyama; Yuko Kitagawa; Go Wakabayashi; Isamu Koyama; Katsuhiko Yanaga; Toshiro Konishi; Ryoji Fukushima; Shiko Seki; Shun Imai; Tsunehiro Shintani; Hiroki Tsukada; Kazuhiro Tsukada; Kenji Omura; Hiroshige Mikamo; Hiromitsu Takeyama; Masato Kusunoki; Shoji Kubo; Junzo Shimizu; Toshihiro Hirai; Hiroki Ohge; Akio Kadowaki; Kohji Okamoto; Katsunori Yanagihara
• Keywords: Microbiology (medical); 0301 basic medicine; Surveillance; Antibiotic susceptibility; Bacteria; Microbial Sensitivity Tests; Anti-Bacterial Agents; 3. Good health; 03 medical and health sciences; Infectious Diseases; Japan; Drug Resistance, Bacterial; Bacteroides fragilis group; Humans; Surgical Wound Infection; Pharmacology (medical); Surgical site infections

To investigate the trends of antimicrobial resistance in pathogens isolated from surgical site infections (SSI), a Japanese surveillance committee conducted the first nationwide survey. Seven main organisms were collected from SSI at 27 medical centers in 2010 and were shipped to a central laboratory for antimicrobial susceptibility testing. A total of 702 isolates from 586 patients with SSI were included. Staphylococcus aureus (20.4 %) and Enterococcus faecalis (19.5 %) were the most common isolates, followed by Pseudomonas aeruginosa (15.4 %) and Bacteroides fragilis group (15.4 %). Methicillin-resistant S. aureus among S. aureus was 72.0 %. Vancomycin MIC 2 μg/ml strains accounted for 9.7 %. In Escherichia coli, 11 of 95 strains produced extended-spectrum β-lactamase (Klebsiella pneumoniae, 0/53 strains). Of E. coli strains, 8.4 % were resistant to ceftazidime (CAZ) and 26.3 % to ciprofloxacin (CPFX). No P. aeruginosa strains produced metallo-β-lactamase. In P. aeruginosa, the resistance rates were 7.4 % to tazobactam/piperacillin (TAZ/PIPC), 10.2 % to imipenem (IPM), 2.8 % to meropenem, cefepime, and CPFX, and 0 % to gentamicin. In the B. fragilis group, the rates were 28.6 % to clindamycin, 5.7 % to cefmetazole, 2.9 % to TAZ/PIPC and IPM, and 0 % to metronidazole (Bacteroides thetaiotaomicron; 59.1, 36.4, 0, 0, 0 %). MIC₉₀ of P. aeruginosa isolated 15 days or later after surgery rose in TAZ/PIPC, CAZ, IPM, and CPFX. In patients with American Society of Anesthesiologists (ASA) score ≥3, the resistance rates of P. aeruginosa to TAZ/PIPC and CAZ were higher than in patients with ASA ≤2. The data obtained in this study revealed the trend of the spread of resistance among common species that cause SSI. Timing of isolation from surgery and the patient's physical status affected the selection of resistant organisms.