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

  • Surveillance
  • Published:
Journal of Infection and Chemotherapy

Abstract

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.

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Conflict of interest

Yoshio Takesue has received a speaker’s honorarium from Taisho Toyama Pharm. Co., Ltd, MSD Japan, Astellas Pharma Inc. and Pfizer Japan Inc. Akira Watanabe is a consultant to Daiichi-Sankyo Co., Ltd, Mitsubishi Tanabe Pharma Corporation, Toyama Chemical Co., Ltd, and Otsuka Pharmaceutical Co., Ltd. A.W. has received a speaker’s honorarium from MSD Japan, Glaxo SmithKline K.K., Shionogi & Co. Ltd., Daiichi-Sankyo Co., Ltd, Taisho Toyama Pharmaceutical, Dainippon Sumitomo Pharma Co., Ltd, and Pfizer Japan Inc. and grant support from Astellas Pharma Inc., Kyorin Pharmaceutical Co., Ltd, Shionogi & Co. Ltd., Taisho Pharmaceutical Co., Ltd, Toyama Chemical Co., Ltd, Daiichi Sankyo Co., Ltd, Dainippon Sumitomo Pharma Co., Ltd, Taiho Pharma Co., Ltd, and Meiji Seika Pharma Co., Ltd. Shinya Kusachi has received a speaker’s honorarium from Shionogi & Co., Ltd, MSD Japan, and Taisho Toyama Pharmaceutical Co., Ltd. Keisuke Sunakawa received a research grant from Meiji Seika Pharma Co., Ltd. and Taisho Toyama Pharmaceutical Co., Ltd. Yuko Kitagawa has received a speaker’s honorarium from Chugai Pharmaceutical Co., Ltd, Taiho Pharmaceutical Co., Ltd, Shionogi & Co., Ltd, Coviden Japan Co., Ltd, and Ethicon Endo-Surgery, LLC. Y.K received a research grant from Chugai Pharmaceutical Co., Ltd, Taiho Pharmaceutical Co., Ltd, and Yakult Honsha Co., Ltd.

Author information

Authors and Affiliations

  1. Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan

    Yoshio Takesue, Akira Watanabe, Shinya Kusachi, Tetsuro Matsumoto, Aikichi Iwamoto, Kyoichi Totsuka, Keisuke Sunakawa, Morimasa Yagisawa, Junko Sato, Toyoko Oguri & Kunio Nakanishi

  2. Hyogo College of Medicine Hospital, Hyogo, Japan

    Yoshio Takesue

  3. Kitasato University Institute, Tokyo, Japan

    Hideaki Hanaki

  4. Toho University Medical Center Ohashi Hospital, Tokyo, Japan

    Shinya Kusachi

  5. Japan Society for Surgical Infection, Tokyo, Japan

    Yoshinobu Sumiyama & Yuko Kitagawa

  6. Toho University, Tokyo, Japan

    Yoshinobu Sumiyama

  7. Keio University Hospital, Tokyo, Japan

    Yuko Kitagawa

  8. Iwate Medical University Hospital, Iwate, Japan

    Go Wakabayashi

  9. Saitama Medical University International Medical Center, Saitama, Japan

    Isamu Koyama

  10. The Jikei University Hospital, Tokyo, Japan

    Katsuhiko Yanaga

  11. NTT Medical Center Tokyo, Tokyo, Japan

    Toshiro Konishi

  12. Teikyo University Hospital, Tokyo, Japan

    Ryoji Fukushima

  13. National Hospital Organization Tokyo Medical Center, Tokyo, Japan

    Shiko Seki

  14. Hiratsuka City Hospital, Kanagawa, Japan

    Shun Imai

  15. Shizuoka Red Cross Hospital, Shizuoka, Japan

    Tsunehiro Shintani

  16. Niigata City General Hospital, Niigata, Japan

    Hiroki Tsukada

  17. Toyama University Hospital, Toyama, Japan

    Kazuhiro Tsukada

  18. Koseiren Takaoka Hospital, Toyama, Japan

    Kenji Omura

  19. Aichi Medical University Hospital, Aichi, Japan

    Hiroshige Mikamo

  20. Nagoya City University Hospital, Aichi, Japan

    Hiromitsu Takeyama

  21. Mie University Hospital, Mie, Japan

    Masato Kusunoki

  22. Osaka City University Hospital, Osaka, Japan

    Shoji Kubo

  23. Toyonaka Municipal Hospital, Osaka, Japan

    Junzo Shimizu

  24. Kawasaki Medical School Hospital, Okayama, Japan

    Toshihiro Hirai

  25. Hiroshima University Hospital, Hiroshima, Japan

    Hiroki Ohge

  26. Sanin Rosai Hospital, Tottori, Japan

    Akio Kadowaki

  27. University of Occupational and Environmental Health, Kitakyushu, Japan

    Kohji Okamoto

  28. Nagasaki University Hospital, Nagasaki, Japan

    Katsunori Yanagihara

  29. Department of Infection Control and Prevention, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Yoshio Takesue

Authors
  1. Yoshio Takesue
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  2. Akira Watanabe
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  3. Hideaki Hanaki
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  32. Hiroki Ohge
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  33. Akio Kadowaki
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  34. Kohji Okamoto
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  35. Katsunori Yanagihara
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Corresponding author

Correspondence to Yoshio Takesue.

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Takesue, Y., Watanabe, A., Hanaki, H. et al. Nationwide surveillance of antimicrobial susceptibility patterns of pathogens isolated from surgical site infections (SSI) in Japan. J Infect Chemother 18, 816–826 (2012). https://doi.org/10.1007/s10156-012-0509-1

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  • DOI: https://doi.org/10.1007/s10156-012-0509-1

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