メタロβ-ラクタマーゼ遺伝子blaIMP陽性グラム陰性桿菌検出症例の臨床的検討

中野 哲治; 平松 和史; 平田 範夫; 村上 純子; 一宮 朋来; 時松 一成; 山形 英司; 山上 由理子; 山崎 透; 永井 寛之; 門田 淳一; 那須 勝; 中野 忠男; 犀川 哲典

doi:10.11150/kansenshogakuzasshi1970.75.946

Clinical Characterization of bla_IMP Positive Gram-negative Rods Isolated Cases

Tetsuji NAKANO, Kazufumi HIRAMATSU, Norio HIRATA, Junko MURAKAMI, Tomoku ICHIMIYA, Issei TOKIMATSU, Eiji YAMAGATA, Yuriko YAMAKAMI, Tohru YAMASAKI, Hiroyuki NAGAI, Jun-ichi KADOTA, Masaru NASU, Tadao NAKANO, Tetsunori SAIKAWA

Author information

Tetsuji NAKANO
Second Department of Internal Medicine, Oita Medical University Hospital
Kazufumi HIRAMATSU
Clinical Laboratory Center, Oita Medical University Hospital
Norio HIRATA
Second Department of Internal Medicine, Oita Medical University Hospital
Junko MURAKAMI
Second Department of Internal Medicine, Oita Medical University Hospital
Tomoku ICHIMIYA
Second Department of Internal Medicine, Oita Medical University Hospital
Issei TOKIMATSU
Second Department of Internal Medicine, Oita Medical University Hospital
Eiji YAMAGATA
Second Department of Internal Medicine, Oita Medical University Hospital
Yuriko YAMAKAMI
Second Department of Internal Medicine, Oita Medical University Hospital
Tohru YAMASAKI
Second Department of Internal Medicine, Oita Medical University Hospital
Hiroyuki NAGAI
Second Department of Internal Medicine, Oita Medical University Hospital
Jun-ichi KADOTA
Second Department of Internal Medicine, Oita Medical University Hospital
Masaru NASU
Second Department of Internal Medicine, Oita Medical University Hospital
Tadao NAKANO
Clinical Laboratory Center, Oita Medical University Hospital
Tetsunori SAIKAWA
Clinical Laboratory Center, Oita Medical University Hospital

Keywords: bla_IMP, metallo-β-lactamase, multidrug resistance, Pseudomonas aeruginosa, Serratia marcescens

JOURNAL FREE ACCESS

2001 Volume 75 Issue 11 Pages 946-954

DOI https://doi.org/10.11150/kansenshogakuzasshi1970.75.946

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Abstract

We detected the metallo-β-lactamase gene bla_IMP positive strains of the gram-negative rods (GNR) isolated in Oita Medical University Hospital between 1993 and 1999 and studied the clinical characteristics of patients infected or colonized with bla_IMP positive GNR. 25 strains (20 Pseudomonas aeruginosa and 5 Serratia marcescens) were detected and most of them were isolated from urinary samples after 1997. In the studies of antimicrobial susceptibility, some strains had sensitivity to aztreonum or imipenem although most of the strains showed multidrug resistance.
When bla_IMP positive GNR were isolated from patients, these strains were thought to have caused infection in 88% of the patients. About half of the patients were over 65 years old and had malignant diseases. Most of the patients had inserted urinary tract catheters, intratracheal tube or intravernous catheters. It was suggested that the insertion of the catheters were related to infection of bla_IMP positive GNRs. Two patients were not treated with any antibiotics before the isolation of Ham, positive GNRs although more than half of the patients were administered carbapenems and cephems. Most of strains were isolated in the same department and showed the same genotype by pulsed field gel electrophoresis.

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