Antimicrobial Susceptibility and Genetic Characteristics of Streptococcus pneumoniae Isolates Indicating Possible Nosocomial Transmission Routes in a Community Hospital in Japan

Abstract

A clinical study was designed to study Streptococcus pneumoniae isolates recovered from a community hospital in Japan from April 2001 to November 2002. A total of 73 isolates were defined as derived from inpatient, outpatient, and hospital staff groups. The MIC results showed that 20 strains (27.4%) were susceptible to penicillin G, 39 strains (53.4%) had intermediate resistance, and 14 strains (19.2%) had full resistance. Low susceptibility to macrolides was also detected: 32.9%, 32.9%, and 34.2% of all strains were resistant to erythromycin, clarithromycin, and azithromycin, respectively. Thirty strains (41%) were resistant to at least two different kinds of antibiotics. Nineteen disparate serotypes were detected besides two nontypeable strains, and the predominant serotypes were 19F and 23F. Pulsed-field gel electrophoresis (PFGE) pattern A was dominant in the serotype 19F group; this pattern was similar to that of the international clone Taiwan 19F. A total of 10 different patterns were detected in the 23F group and were distinguishable from those of the international clones Spain 23F and Taiwan 23F. Pattern b strains were identified in the same ward, and pattern d strains were found both in patients with nosocomial pneumococcal infections (NPI) and in outpatients. In conclusion, drug-resistant S. pneumoniae was spreading rapidly, especially isolates of the serotype 19F and 23F groups. PFGE data revealed interpatient transmission and suggested that there might be some association between NPI patient strains and outpatient strains.

Serotype Replacement in Adult Pneumococcal Pneumonia after the Introduction of Seven-Valent Pneumococcal Conjugate Vaccines for Children in Japan: a Systematic Literature Review and Pooled Data Analysis

“…All of the studies were performed in the pre-PCV13 period. The study designs could be categorized into case series of pneumococcal LRTI (15,16), prospective surveillance of pneumococcal LRTI or IPD cases (1,(17)(18)(19)(20), and laboratory-based pneumococcal strain surveillance (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). One of the prospective surveillance studies of the LRTI referred to the Japanese Respiratory Society (JRS) guidelines for the management of community-acquired pneumonia in adults (36) as diagnostic criteria for LRTI (17).…”

Comparison of clinical features, antimicrobial susceptibility, serotype distribution and outcomes of patients with hospital- and community-associated invasive pneumococcal disease

“…Similarly, Lee et al [10] showed that isolates of serotypes 23F (33.3% vs. 11.9%) and 19F (31.3% vs. 23.9%) were more frequent causes of nosocomial pneumococcal infection. Serotypes 23F and 19F, which have the highest rates of PNSSP, were found to be the predominant strains in nosocomial pneumococcal transmission in Japan [23]. These serotypes were also responsible for the spread of pneumococcal strains with high ␤-lactam resistance in Taiwan [14,24], including the international clones Taiwan 23F , Spain 23F and Taiwan 19F .…”

Frequency and antibiotic susceptibility of gram-positive bacteria in Makkah hospitals

“…For example, in a study performed at King Saud University in Riyadh, Fouda et al found that 44.6% of the Streptococcus pneumoniae isolates were susceptible to penicillin 21. In a study conducted in Japan, Qin et al found that 27.4% of the Streptococcus pneumoniae isolates were susceptible to penicillin 22. Similarly, in another study conducted in Taiwan, the resistance rate of Streptococcus pneumoniae to penicillin was 69% 13…”