M Kouda

Tokyo Metropolitan Police Hospital, Edo, Tōkyō, Japan

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Publications (14)1.24 Total impact

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    ABSTRACT: MICs of various antibacterial agents against methicillin-resistant Staphylococcus aureus (MRSA) were measured. Furthermore, we evaluated the effects of combinations of antibacterial agents against MRSA in vitro. In 24 cases out of 37, in which MRSA was isolated from inpatients, other microorganisms, such as Candida spp., Entrococcus spp., and Pseudomonas aeruginosa, were simultaneously isolated. From the results of minimum inhibitory concentrations (MICs), obtained from micro broth-dilution method, of various antibacterial agents against MRSA, range of MICs of arbekacin (ABK), vancomycin (VCM) and teicoplanin (TEIC) were < or = 0.25-4.0, 0.5-1.0 and 0.25-4.0 micrograms/ml respectively, and no strains of MRSA showed resistance to ABK, VCM and TEIC, so that we concluded that these three antibacterial agents were effective for MRSA infection. On the in vitro study of combination-effect of antibacterial agents, significant synergistic effects were achieved in the combination of VCM and flomoxef (FMOX) (Synergism rate was 97.3%) or VCM and imipenem (IPM) (Synergism rate was 97.2%). From the results that the fractional inhibitory concentration index in the combination of VCM with IPM was smaller than that with FMOX and that P. aeruginosa or Enterococcus spp. were simultaneously isolated in high frequency in the MRSA-isolated cases, we thought that the combination of VCM with IPM is more useful, because IPM is effective against P. aeruginosa but FMOX is not.
    No preview · Article · Apr 2000 · The Japanese journal of antibiotics
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    ABSTRACT: We investigated the differences in judgments among four disc-diffusion methods on susceptibility testing of arbekacin (ABK), vancomycin (VCM) and teicoplanin (TEIC) against 37 strains of methicillin-resistant Staphylococcus aureus (MRSA). These results were compared with minimum inhibitory concentrations (MICs) obtained from micro broth-dilution method. A marked difference was noted in the judgment of susceptibility to TEIC in Tri-disc method, that is 2 strains (5.4%) fell into sensitive (+3) 34 strains (91.9%) into moderately sensitive (+2) and 1 strain (2.7%) into moderately resistant (+), while in Sensi-disc method all strains fell into sensitive (S). According to the MICs, no strain of the MRSA tested revealed resistance to ABK, VCM and TEIC. Consequently, these three antimicrobial agents were thought to be effective on MRSA infections. From these results, we concluded that Tri-disc method for glycopeptide against MRSA, especially for TEIC, is not recommendable as a disc-diffusion method in susceptibility testing.
    No preview · Article · Jan 2000 · The Japanese journal of antibiotics
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    ABSTRACT: Antibacterial activity of various antibiotics against Pseudomonas aeruginosa isolated from each hospitals depends on the variety or amount of antibiotics used in each hospital. The antibiotic, which is effective to P. aeruginosa in a certain hospital is not always effective to that in other hospital. The excellent antibiotics in antibacterial activity have low MIC and hard to progress in resistance, and such antibiotics may be effective against P. aeruginosa isolated from any hospitals. Therefore we thought that the antibiotic, which was progress to resistance, would show a great difference in MIC among hospitals, and we investigated MIC and difference of MIC of various antibiotics against P. aeruginosa isolated from six hospitals. Furthermore, we converted the data of MICs and difference of MIC among six hospitals into the score, and tried to estimate antibacterial activity of various antibiotics by using those scores. From the results of analysis in this report, we think the antibiotics actually surpass in antibacterial activity may be imipenem, cefozopran, cefsulodin and amikacin. New analytical method proposed in this report will become one of potential methods to estimate antibacterial activity of antibiotics against bacteria isolated from inpatient with bacterial infections.
    No preview · Article · Jul 1999 · The Japanese journal of antibiotics
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    ABSTRACT: MICs of piperacillin, sulbactam/cefoperazone, minocycline (MINO), gentamicin, amikacin, flomoxef, ceftazidime, cefozopran, cefsulodin and imipenem were determined, against 189 clinical isolated strains of glucose non-fermentative Gram-negative Rods (NFGNR; Acinetobacter baumannii (44), Alcaligenes faecalis (5), Alcaligenes xylosoxidans (25), Burkholderia cepacia (12), Chryseobacterium indologenes (23), Chryseobacterium meningosepticum (9), Pseudomonas fluorescens (8), Pseudomonas putida (12), Stenotrophomonas maltophilia (51). Most species of these NFGNR show resistance to many antibiotics tested. Among the antibiotics used in this study, the only antibiotic effective against all species of NFGNR tested is MINO. The spectrums of antibacterial activities of various antibiotics determined by MICs may be useful in preliminary test for identification of these NFGNR.
    No preview · Article · Aug 1998 · The Japanese journal of antibiotics
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    ABSTRACT: With regard to antibiotics susceptibility testing, although it is understood that antibiotics belonging to the same class generally have similar antibacterial activity, some clinical isolates show considerably different susceptibility rates, and it has regarded as characteristics of each antibiotic. In this report, we determined the detection rates of organisms isolated from clinical specimens and analyzed the results of antibacterial susceptibility testing of imipenem and panipenem against these isolates. From the above investigation, we consider the bacteriological characteristics of imipenem and panipenem to be as follows: 1) The antibacterial activity of imipenem against Pseudomonas aeruginosa is superior to that of panipenem. 2) Completely susceptible rate of Enterococcus faecalis and Acinetobacter baumanii against imipenem is slightly higher than against panipenem. 3) Against other bacteria other than those given above, the antibacterial activities of imipenem and panipenem are essentially the same. 4) Except for methicillin-resistant Staphylococcus aureus and P. aeruginosa, there are only a few strains which are completely resistant to these two carbapenems.
    No preview · Article · Jan 1996
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    ABSTRACT: MICs of imipenem (IPM), panipenem (PAPM), cefozopran (CZOP), cefpirome (CPR), gentamicin (GM), tobramycin (TOB) and amikacin (AMK) against Pseudomonas aeruginosa were determined using Mueller-Hinton agar and low-amino-acid agar. On Mueller-Hinton agar, the antibacterial activity of TOB was superlative, followed in order by GM, CZOP, IPM, AMK, PAPM and CPR, whereas on low-amino-acid agar, the order changed to IPM, PAPM, TOB, CZOP, GM, AMK and CPR. The largest decrease of MICs was seen with PAPM on low-amino-acid agar, and the antibacterial activity of PAPM was not stronger than that of IPM. The growth of P. aeruginosa on the low-amino-acid agar were significantly weaker than that on Mueller-Hinton agar, hence the evaluation of appearance colonies was difficult and misjudgement may result. Based on the above observations, we believe further investigations are needed before the application of low-amino-acid agar becomes routine.
    No preview · Article · Nov 1995 · The Japanese journal of antibiotics
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    ABSTRACT: In recent years, isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) has decreased, while the rate of Pseudomonas aeruginosa has increased. This phenomenon may be a result of regulation of use of antibiotics which belongs to the third cephems and extensive preventive measures against hospital acquired infections due to MRSA. Based on our investigation in which we determined MICs of various antibiotics against P. aeruginosa strains isolated from inpatients, the antibacterial activities of cefclidin (CFCL) was superior to those of other antibiotics. The antibacterial activity of CFCL against P. aeruginosa tested was similar to or stronger than that of tobramycin.
    No preview · Article · Jul 1995 · The Japanese journal of antibiotics
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    ABSTRACT: We evaluated combined effects of sulbactam/cefoperazone (SBT/CPZ) with each of imipenem/cilastatin (IPM), cefuzonam, flomoxef, amikacin (AMK) and tobramycin (TOB) against 324 clinical strains. Through this study, we obtained the following results. 1. Against Serratia marcescens and Enterobacter cloacae, good synergism was obtained by combining SBT/CPZ with IPM, AMK, or TOB. 2. Against Pseudomonas aeruginosa, good synergism was obtained by combining SBT/CPZ with AMK or TOB. 3. When SBT/CPZ was used in combination with IPM, antagonism was observed among about 45% of strains of P. aeruginosa.
    No preview · Article · Mar 1991 · The Japanese journal of antibiotics
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    ABSTRACT: The MICs of Aztreonam (AZT) against 590 clinical isolates of Gram-negative bacilli were determined. About 13.4% (79 strains) of the isolates were AZT-resistant (MIC; 12.5 micrograms/ml less than or equal to). The resistance pattern against various beta-lactams and the effects on MICs of combination of Clavulanic acid (CVA) and AZT against AZT resistant strains suggested that AZT was inactivated by either type of IV (K1), Va (OXA1), or PSE2 beta-lactamases.
    Preview · Article · Nov 1990 · Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases
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    ABSTRACT: We evaluated relationships between production of beta-lactamase and their resistances to beta-lactams, effect of sulbactam (SBT), a beta-lactamase inhibitor, against beta-lactam resistant strains, and combined effect of sulbactam/cefoperazone (SBT/CPZ) with other antibiotics against multi-resistant strains. Through these studies, we obtained the following results. 1. Most of the strains resistant to beta-lactams were beta-lactamase producers. 2. Relationships between the production of beta-lactamase and their resistances to beta-lactams indicate that their resistances generally were the highest in producers of both penicillinase (PCase) and cephalosporinase (CEPase), moderate in producers of either PCase or CEPase, and the lowest in beta-lactamase non-producers. Most of highly-resistant strains of MRSA appeared to be beta-lactamase non-producers though some exceptions were observed among methicillin-resistant Staphylococcus aureus (MRSA), Serratia marcescens and Pseudomonas aeruginosa. 3. SBT showed good effect against PCase producers, moderate effect against producers of both PCase and CEPase, little effect against CEPase producers, and no effect against beta-lactamase non-producers. 4. Results of combined effect of SBT/CPZ with other antibiotics indicated that good synergism was obtained by combining SBT/CPZ with fosfomycin (FOM) or piperacillin against multi-resistant strains of Proteus spp., Enterobacter cloacae, and S. marcescens, by combining SBT/CPZ with ceftazidime (CAZ) or FOM in methicillin-sensitive S. aureus and by combining SBT/CPZ with CAZ in P. aeruginosa. 5. Better synergism was obtained with the higher concentrations of antibiotics.
    No preview · Article · May 1990 · The Japanese journal of antibiotics
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    ABSTRACT: We evaluated the kits for grouping β-hemolytic streptococci. Streptococcal Grouping Kit (Oxoid), which can identify the streptococci of Group A, B, C, D, G and F simultaneously, was superior to other kits which were tested. However, by using this kit, we found that Streptococcus pneumoniae has a cross-reactive antigen with Group C Streptococcus and the antigen may exist in the cell wall of S. pneumoniae.We also measured MICs to gentamicin (GM) against clinical isolates of β-streptococci. The MICs of GM to Group A and B Streptococcus were relatively low (1.56-3.13μg/ml), whereas the MICs of the other groups of Streptococcus were higher than those of the former. These results indicated that susceptibility of β-hemolytic streptococci to GM is useful as one of the tests to identify β-hemolytic streptococci.Furthermore, we studied the frequency of isolation of β-hemolytic streptococci from the clinical specimens. The results showed that frequency of isolation of Group F Streptococcus was higher than that of Group C and G Streptococcus from the clinical specimens, although it is previously said that most of the clinical isolates of β-hemolytic streptococcus were Group A, B, C or G.
    Preview · Article · Jun 1988 · Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases
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    ABSTRACT: Recently, the isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) from clinical specimens are increasing.Such tendency was also observed with the organisms isolated from blood cultures in our hospital.Increase of S. aureus in isolation rate and multiple antibiotic resistance seemed to be related to increased usage of antibiotics which were effective to gram-positive cocci.In 1985, 96 percent of S. aureus isolated from blood cultures in our hospital were β-lactamase producers or MRSA (MRSA were seen at 78 percent).Results obtained from measurement of MIC of various antibiotics nd several antibiotic combinations against MRSA, indicated that minocyclin, netilmicin, combination of fosfomycin and methicillin, or combination of fosfomycin and cephems are effective against septicemia caused by MRSA.
    Preview · Article · Dec 1987 · Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases
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    ABSTRACT: β-hemolytic streptococci, particularly members of Strebtococcus bvogenes, are important pathogens which cause various acute infections and post-streptococcal diseases. It is not uncommon that organisms of S. pyogenes are isolated from the throat of apparently healthy children. Therefore, the etiologic significance of a small number of S. pyogenes detected from children with symptoms of upper respiratory infections has not been determined yet. Thus there have been few laboratories which use a selective enrichment broth for detection of S. pyogenes.We made a clinical evaluation on the employment of a selective enrichment broth (SEB, Nissui Seiyaku) in detecting S. pyogenes from throat specimens of children, who visited the outpatient clinic at our hospital. It was observed that even a small number of S. pyogenes only detectable by employment of the SEB showed an etiologic relationship with the disease. The results indicated the usefulness of the SEB for culturing throat specimens from the children.
    Preview · Article · Jun 1987 · Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases
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    ABSTRACT: A method of rapid susceptibility testing by bioluminescent assay was developed. Correlation between the 50% inhibition dose of antimicrobics for bacterial adenosine triphosphate measured by bioluminescent assay and the minimum inhibitory concentration obtained by the broth dilution method was satisfactory. In the bioluminescent assay the incubation time required was only 90 min.
    Preview · Article · Feb 1985 · Microbiology and Immunology