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Query: UMLS:C0519030 (Klebsiella)
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Changes in the susceptibility of various infectious microorganisms to antimicrobial agents from 1982 to 1986 were evaluated. The microorganisms investigated were Escherichia coli, Klebsiella spp., Citrobacter spp., Enterobacter spp., Proteus spp., Serratia marcescens and Pseudomonas aeruginosa isolated from patients with urinary tract infections. We compared susceptibilities of microorganisms obtained from simple urinary tract infections with those from complicated infections with or without indwelling catheter. Among penicillins, mecillinam (MPC) showed the strongest activity against E. coli obtained from the patients: 3.13 to 6.25 micrograms/ml of MPC inhibited the growth of over 90% of the isolates. Among the second and the third generation cephalosporins, cefotiam and cefmenoxime (CMX) showed the strongest activity and the growth of isolates was inhibited at concentrations of 0.39 to 0.78 microgram/ml and below 0.10 to 0.20 microgram/ml, respectively. The activities of penicillins against Klebsiella spp. were weak. CMX showed strong activity against Klebsiella spp; 91.7% of the isolates from patients with simple infections were inhibited at 0.39 microgram/ml of the agent; 90.7% and 91.6% of isolates from patients with complicated infections with or without indwelling catheter were inhibited at 0.78 microgram/ml and 1.56 microgram/ml of the agent, respectively. Gentamicin (GM) also showed strong activity against isolates from patients with simple infections and weaker activity against isolates from patients with complicated infections with the catheter; 0.78 microgram/ml of ofloxacin (OFLX) inhibited the growths of 90% of the isolates from these patients. Penicillins showed weak activity against Citrobacter spp. obtained from the patients. Among the second and the third generation cephalosporins, CMX and latamoxef (LMOX) showed strong activities against the Citrobacter isolates; about 50% of the isolates were inhibited at 0.20 microgram/ml of either agent. 1.56 microgram/ml of minocycline inhibited the growth of 75 to 90% of the isolates and 1.56 microgram/ml of OFLX inhibited the growth of 93 to 100% of the isolates. Against isolates of Proteus spp. penicillins also showed weak activities. Among them, however, piperacillin (PIPC) inhibited the growth of over 90% of the isolates at concentrations ranging from 0.78 to 1.56 micrograms/ml. Among the second and third generation cephalosporins, CMX and LMOX showed strong activities; 0.20 microgram/ml of CMX inhibited the growth of 94.4%, 90.4%, and 83.1% of isolates from the 3 types of the patients, respectively. 0.20 microgram/ml of LMOX inhibited the growth of 94.4%, 91.8%, and 88.3% of the isolates, respectively. Enterobacter spp. showed resistance to the beta-lactam antibiotics.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1986). III. Secular changes in susceptibility]. 260 4

Our research group was engaged for 3 years (1979-1981) in a study on sensitivities to antibiotics of 4 bacterial groups including representative pathogenic bacteria found in cases of urinary tract infections; i.e. E. coli, Klebsiella spp., Citrobacter spp., and Proteus spp. Since 1982, all the bacterial strains isolated by our group from patients with urinary tract infections and deemed by doctors in charge as pathogens were sent to the Laboratory of Clinical Pathology of Juntendo University, where they were refixed and subjected to MIC determination. This is the third year of the new study. E. coli was detected most frequently from patients with urinary tract infections and the detection frequency was 28% (323/1,153) this year (1984), whereas it was 35.3% (304/860) last year, showing a 7% decline from last year to this year. E. faecalis was next frequent organism (12.7% or 147/1,153) followed by P. aeruginosa (10.8% or 124/1,153). This order, however, was reversed from last year. Other pathogens, in a decreasing order of isolation frequencies following the above three, were as follows: Proteus spp. (9.5% or 109/1,153), S. marcescens (6.2% or 71/1,153), S. epidermidis (5.4% or 62/1,153), K. pneumoniae (4.9% or 56/1,153), Enterobacter spp. (2.4% or 28/1,153) and Citrobacter spp. (2.3% or 27/1,153). The results of the determination of the sensitivity of bacterial strains to the antibiotics are described below. Of all the oral antibacterial and antibiotic agents used against E. coli, mecillinam (MPC), cefaclor (CCL) and pipemidic acid (PPA) proved to have high antibacterial potency, and their MIC90 (the concentration to inhibit growths of 90% of the objective bacteria) was 3.13 micrograms/ml. The MIC90's of cefotiam (CTM), cefotaxime (CTX), ceftizoxime (CZX), cefmenoxime (CMX) and latamoxef (LMOX) were less than 0.39 microgram/ml. The MIC90's of cefmetazole (CMZ) and cefoperazone (CPZ) were invariably 1.56 micrograms/ml. K. pneumoniae was not sensitive to ampicillin (ABPC) and did not show much sensitivity to other oral antibacterial and antibiotic agents also. Of all the injectable preparations of antibiotics, cephem antibiotics of the third generation showed the most potent antibacterial effects against K. pneumoniae, and their MIC90's were lower than 0.10 microgram/ml for CZX, 0.20 microgram/ml for CTX, 0.39 microgram/ml for CMX, and 0.78 microgram/ml for LMOX, while MIC90's of CPZ was 6.25 micrograms/ml, which was equal to that of CMZ. The MIC90 of CTM was 0.78 microgram/ml which was identical to that of LMOX.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Comparative studies of antimicrobial agents against causative organisms isolated from urinary tract infections (1984). I. Susceptibility distribution]. 310 8

The results of determinations of sensitivities of bacterial strains to various antibiotics are summarized as follows: 1. Against Escherichia coli, ofloxacin (OFLX) showed the strongest activity among oral antibacterial and antibiotic agents. Its MIC90 was below 0.10 micrograms/ml. The next strongest activity was found in mecillinam (MPC), cefaclor (CCL) and pipemidic acid (PPA); MIC90's of these agents 3.13 micrograms/ml. Cefotiam (CTM), cefotaxime (CTX), ceftizoxime (CZX), cefmenoxime (CMX) and latamoxef (LMOX) had MIC90 below 0.39 micrograms/ml. MIC90's of cefmetazole (CMZ) and cefoperazone (CPZ) were 1.56 micrograms/ml. Aztreonam (AZT) and carumonam (CRMN) in the monobactam group showed strong activities with MIC90's at 0.20 micrograms/ml. 2. Although Klebsiella pneumoniae had a strong resistance to ampicillin (ABPC) and showed relatively low sensitivities to other oral antibacterial and antibiotic agents, OFLX maintained high activity against this species and showed MIC90 of 0.39 micrograms/ml. Among injectable antibiotics, third generation cephems showed the strongest activity to this species with MIC90 of CZX below 0.10 micrograms/ml, of CTX and CMX 0.20 micrograms/ml, and of LMOX 0.78 micrograms/ml. MIC90 of CPZ was 6.25 micrograms/ml, which was the same as those of cefazolin (CEZ) and cefoxitin (CFX). CTM had similar MIC90 to LMOX, namely, 1.56 micrograms/ml. MIC90 of CMZ was 3.13 micrograms/ml. Monobactams AZT and CRMN showed strong activities to this species; their MIC90's were below 0.10 micrograms/ml and 0.20 micrograms/ml. 3. Although Citrobacter freundii generally exhibited low sensitivities to antibacterial and antibiotic agents examined, it showed high sensitivity to OFLX, at MIC80 of 0.78 micrograms/ml. This species showed low sensitivities to MPC, nalidixic acid (NA), PPA, and sulfamethoxazole-trimethoprim (ST). Among injectable antibiotics, LMOX and CMX had activities against this species; namely, MIC80's were 6.25 and 3.13 micrograms/ml, respectively. Among monobactams, AZT showed MIC80 of 12.5 micrograms/ml, and CRMN had that of 6.25 micrograms/ml. 4. Against Enterobacter cloacae, the strongest antibacterial activity was found with OFLX which had MIC90 of 0.39 micrograms/ml. A relatively strong activity was seen with MPC. MIC80 of MPC was 1.56 micrograms/ml. Except to CTM, this species had poor sensitivities to injectable first and second generation cephems, and their MIC80's were over 200 micrograms/ml. MIC80 of CTM was 25 micrograms/ml.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1985). I. Susceptibility distribution]. 344 55

Sensitivities to antimicrobial agents of Escherichia coli, Klebsiella spp., Citrobacter spp., Enterobacter spp., Proteus spp., Pseudomonas aeruginosa and Serratia marcescens isolated from infected patients were evaluated and compared according to the types of their infections, i.e., simple and complicated urinary tract infections with or without indwelling catheter. There were no apparent decreases in the sensitivity of E. coli isolated from patients with simple urinary tract infections. When data obtained in 1982-1985 were summarized, it was found that a new quinoline derivative, ofloxacin (OFLX), showed the strongest activity among oral antimicrobial and antibiotic agents. This agent inhibited 100% of bacterial growth at MIC of 1.56 micrograms/ml. The next strongest activity was found with mecillinam (MPC) which showed 89.3% growth inhibition at the same concentration. Cefaclor (CCL) also showed 84.9% growth inhibition at the same concentration. When sensitivities of E. coli isolated from patients with complicated urinary tract infections with or without indwelling catheter to first and second generation cephems were determined, cefotiam (CTM), which inhibited 88.9%: 91.4% bacterial growth at MIC of 0.39 micrograms/ml, had the strongest activity among CTM, cefazolin (CEZ), cefoxitin (CFX) and cefmetazole (CMZ). Among third generation cephems, including cefmenoxime (CMX), latamoxef (LMOX), ceftizoxime (CZX), cefotaxime (CTX) and cefoperazone (CPZ), the strongest activity was observed with CZX, and the agent having the next strongest activity was CMX. LMOX and CPZ showed relatively low activities. Carumonam (CRMN) and aztreonam (AZT), monobactams, showed strong activities against E. coli. As for Klebsiella spp., activities of pencillins against these strains were low. When activities of oral cephems (cephalexin (CEX) and CCL) and of a quinoline derivative OFLX against these strains were determined, OFLX showed strong activity; i.e., the growth of Klebsiella spp. isolated from complicated urinary tract infections was inhibited at 87.2%: 82.1% at MIC of 0.20 micrograms/ml.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1985). III. Secular changes in susceptibility]. 344 56

Sub-MIC range of 8 kinds of beta-lactam antibiotics and 3 kinds of aminoglycoside antibiotics against strain of Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa isolated from clinical source were determined by nephlometic method, and following results were obtained. When 10 strains of S. aureus tested to ampicillin (ABPC), hetacillin (IPABPC), mecillinam (MPC), cephalexin (CEX), cefotaxime (CTX), latamoxef (LMOX), cefatrizine (CFT), cephapirin (CEPR), gentamicin (GM), dibekacin (DKB) and amikacin (AMK), ratio of MIC to MAC were 36.8, 53.6, 156.8, 29.6, 61.6, 34.4, 50.0, 111.2, 9.2, 20.0 and 13.6, respectively. When 10 strains of K. pneumoniae tested to MPC, CEX, CTX, LMOX, CFT, CEPR, GM, DKB and AMK, ratio of MIC to MAC were 409.6, 10.4, 34.4, 123.2, 39.2, 167.2, 5.2, 5.6 and 13.2, respectively. When 10 strains of P. aeruginosa tested against CTX, LMOX, GM, DKB and AMK, ratio of MIC to MAC were 16.8, 38.4, 6.8, 3.2 and 10.4, respectively.
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PMID:[Studies on sub-MIC activities of beta-lactam antibiotics and aminoglycoside antibiotics against clinically isolated strain]. 393 20

During 1979-1983 in vitro activities of antimicrobial agents against causative bacteria isolated from patients with urinary tract infections (UTI) were investigated by Microbiological Research Group of UTI including the 8 institutions in Japan. Of all strains (219) isolated from patients with simple UTI, 65.3% were E. coli, and 9.6% Klebsiella spp.; these species accounted for about 75% of all isolates in 1983. MPC and CCL among the oral antimicrobial agents have showed potent activities against E. coli, MPC at 1.56 micrograms/ml and CCL at 3.13 micrograms/ml inhibited 80% of E. coli from simple and complicated UTI. CTM, CTX, CZX, CMX and LMOX among the parenteral antimicrobial agents, at concentrations of 0.20 micrograms/ml or less inhibited 90% of E. coli isolated from simple and complicated UTI. The frequency of isolates from patients with complicated UTI, without catheter, was as follows; E. coli 27.6%, P. aeruginosa 20.1%, Streptococcus spp. 12.6%, Serratia spp. 8.8% and Klebsiella spp. 8.0%. The frequency of isolates from patients with complicated UTI, indwelling catheter, was as follows; P. aeruginosa 22.6%, Streptococcus spp. 18.0%, Serratia spp. 15.0%, Proteus spp. 12.4%, and Enterobacter spp. and Klebsiella spp. are 6.0%, respectively, in 1983. The antibacterial activity (MIC80) against E. coli, Klebsiella spp., P. mirabilis, Citrobacter spp. and Serratia marcescens from simple and complicated UTI was compared, for example, among third generation cephem antibiotics. Four drugs such as CMX, CZX, CTX and LMOX showed virtually comparable activities while CPZ was slightly less active against the strains tested. There have been many studies reported concerning the antibacterial activity of various drugs against clinical isolates from patients with infections, but it seems that, to our knowledge, no article has dealt with yearly surveys on antimicrobial susceptibility of bacterial isolates from defined clinical specimens with the same period of each year at the same series of institutions.
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PMID:[Comparative studies of antimicrobial agents against causative organisms isolated from urinary tract infections (1983). I. Susceptibility distribution]. 407 3

In vitro activities of antibacterial agents against E. coli, Klebsiella, Citrobacter and Proteus which were isolated from patients with urinary tract infections at 8 hospitals in Japan, were investigated by dilution broth method using MIC 2000 (Dynatec) during July to October in 1981. The summarized results are as follows: Among oral antibacterial agents, MPC and PPA have showed potent antibacterial activities against E. coli and Klebsiella. In vitro activities of oral antibacterial agents against Proteus and Citrobacter showed not so potent. Among the first and second generation's parenteral antibacterial agents, CTM has showed potent antibacterial activities against E. coli and Klebsiella. Among the third generation's parenteral antibacterial agents, CMX, CTX and CZX have showed potent antibacterial activities against E. coli, Klebsiella, Proteus and Citrobacter.
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PMID:[Comparison of antibacterial potencies of oral and parenteral antibiotic preparations against Escherichia coli, Klebsiella, Citrobacter, and Proteus isolated from urinary tract infections (3: 1981) 1. Susceptibility distribution]. 636 12

Since 1979 the antibacterial activity of antibiotics against E. coli, Klebsiella, Citrobacter and Proteus isolated from patients with urinary tract infections has been investigated. The serious transition of susceptibilities of E. coli and Klebsiella could not be recognized in these antibiotics (MPC, ABPC, NA, PPA, CEX, CEZ, CTM, CMZ and CFX). However, a few resistant organisms against the third generation's antibiotics (CTX, CMX, CZX, LMOX and CPZ) have already been appeared, we have to observe these results, continuously.
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PMID:[Comparison of antibacterial potencies of oral and parenteral antibiotic preparations against Escherichia coli, Klebsiella, Citrobacter, and Proteus isolated from urinary tract infections (3: 1981). 2. Changes in bacterial sensitivities]. 636 13

In vitro activities of antibacterial agents against E. coli, Klebsiella, Citrobacter and Proteus which were isolated from patients urinary tract infections at 8 hospitals in Japan, were investigated by agar dilution method from July to October in 1979. The summarized results are as follows. 1. Among oral antibacterial agents, MPC and PPA have showed potent antibacterial activities against E. coli and Klebsiella. Among parenteral antibiotics, CTM was the most active against E. coli and Klebsiella. However, ABPC-resistant E. coli and Klebsiella have appeared to occupy about 40% and 96% of bacteria isolated from urinary tract infections, respectively. 2. In vitro activities of antibacterial agents against Proteus and Citrobacter showed not so potent. 3. Causative organisms in female patients with simple urinary tract infections were mainly E. coli and Klebsiella. 4. Among oral antibacterial agents, PPA have shown similar antimicrobial activities against E. coli isolated from simple and complicated urinary tract infections. ABPC and MPC have been influenced in some degree by these factors. However, parenteral antibiotics are not influenced by these factors. On the other hand, in vitro activities of antibacterial agents against Klebsiella isolated from simple and complicated urinary tract infections were similar.
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PMID:[Compared studies of antimicrobial agents against E. coli, Klebsiella, Citrobacter and Proteus isolated from urinary tract infections]. 704 95

Fluoroquinolones acts by interacting with type II topoisomerases (DNA gyrase and topoisomerases IV). Related to this mechanism of action, bacteria have developed resistance mechanisms consisting in some target mutations (GyrA/GyrB for DNA gyrase and ParC/ParE for topoisomerase IV) or in a reduced access to the target itself, by either decreased permeability or augmented expression of efflux pumps, such as AcrAB and MexAB. Along with these classical mechanisms of chromosomal resistance, the presence of fluoroquinolones resistant proteins (Qnr) has been recently evidenced, codified by transmissible genes by means of plasmids, especially in Enterobacter spp., Escherichia coli and Klebsiella pneumoniae, whereas Proteus mirabilis and non fermenter Gram-negative, like Acinetobacter spp. and Pseudomonas aeruginosa, are not involved in such a kind of resistance. Qnr proteins determine a slight increase in MIC values, which often remains below the susceptibility breakpoint. More relevant is their impact on MPC values. Additionally, new specific resistance mechanisms have been described. AAC(6')-Ib-cr represents the first enzyme able to inactivate, by acetylation, antimicrobials of two different classes, aminoglycosides and fluoroquinolones. However, ciprofloxacin and norfloxacin, but not levofloxacin, are susceptible to this enzyme action. Finally, the presence of another resistance mechanism has been reported, an efflux-pump plasmid-mediated, codified by the QepA gene, which acts by a selective mechanism. Only hydrophilic fluoroquinolones, i.e. norfloxacin and ciprofloxacin, but not all the other ones, i.e. levofloxacin, moxifloxacin, etc, are affected by this mechanism. In the light of these new information, it is clear that, in terms of bacterial resistance, it is not any more possible to assimilate one fluoroquinolones to another, since different molecules can be diversely active, due to the specific resistance mechanism.
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PMID:[Fluoroquinolones and Gram-negative bacteria: antimicrobial activity and mechanisms of resistance]. 1884 19


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