Nationwide surveillance of bacterial respiratory pathogens conducted by the Japanese Society of Chemotherapy in 2007: general view of the pathogens’ antibacterial susceptibility

Abstract

For the purpose of a nationwide surveillance of the antimicrobial susceptibility of bacterial respiratory pathogens in patients in Japan, the Japanese Society of Chemotherapy conducted their second year survey, during the period from January to August, 2007. A total of 1178 strains were collected from clinical specimens obtained from adult patients with well-diagnosed respiratory tract infections. Susceptibility testing was evaluable for 1108 strains (226 Staphylococcus aureus, 257 Streptococcus pneumoniae, 6 Streptococcus pyogenes, 206 Haemophilus influenzae, 120 Moraxella catarrhalis, 122 Klebsiella pneumoniae, and 171 Pseudomonas aeruginosa). A total of 44 antibacterial agents, including 26 beta-lactams (four penicillins, three penicillins in combination with beta-lactamase inhibitors, four oral cephems, eight parenteral cephems, one monobactam, five carbapenems, and one penem), three aminoglycosides, four macrolides (including ketolide), one lincosamide, one tetracycline, two glycopeptides, six fluoroquinolones, and one oxazolidinone were used for the study. Analysis was conducted at the central reference laboratory according to the method recommended by the Clinical and Laboratory Standards Institute (CLSI). The incidence of methicillinresistant Staphylococcus aureus (MRSA) was high, at 59.7%, and the incidences of penicillin-intermediateresistant and -resistant Streptococcus pneumoniae (PISP and PRSP) were 30.4% and 5.1%, respectively. Among Haemophilus influenzae strains, 19.9% of them were found to be beta-lactamase-non-producing ampicillin (ABPC)-intermediately-resistant (BLNAI), 29.1% to be beta-lactamasenon-producing ABPC-resistant (BLNAR), and 6.7% to be beta-lactamase-producing ABPC-resistant (BLPAR) strains. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae was not isolated. Two isolates (1.2%) of Pseudomonas aeruginosa were found to be metallo-beta-lactamase-producing strains, including one (0.6%) suspected multidrug-resistant strain showing resistance to imipenem, amikacin, and ciprofloxacin. These data will be a useful reference for future periodic surveillance studies and for investigations to control resistant infections as well. Continued surveillance is required to prevent the further spread of these antimicrobial resistances.

Efficacy and safety of moxifloxacin for community-acquired bacterial pneumonia based on pharmacokinetic analysis

“…pneumoniae and H. influenzae that are less sensitive to fluoroquinolones have been isolated [10], so there is a need to establish an antimicrobial regimen that has higher efficacy and that can suppress the emergence of drugresistant strains. As an increasing number of PK-PD studies of antimicrobial agents are being conducted, it is becoming clear from in vitro and animal experiments that drug efficacy and suppression of the emergence of resistant strains are closely related to PK.…”

“…AUC 0-24 h and C max estimated by a post hoc method using a population PK model (PPK model) of healthy adults were used for these analyses. For Monte Carlo simulation analysis, the AUC 0-24 h and C max of each patient and the distribution of MIC values for S. pneumoniae (257 strains) determined by the survey of the Japanese Society of Chemotherapy in 2007 [10] were used. Monte Carlo simulation was conducted 10,000 times using SAS ver.…”

Reduction in the incidence of MRSA with use of alcohol-based hand rub solutions and gloves

“…MRSA is very contagious. Niki et al [1] showed that the incidence of MRSA among Staphylococcus aureus strains was 59.7% in Japan. It is spread by direct contact with MRSA-infected people or objects.…”

Immunomodulatory Effects of Macrolide Antibiotics – Part 2: Advantages and Disadvantages of Long-Term, Low-Dose Macrolide Therapy

“…Both macrolide resistance rates and resistance mechanisms, however, vary considerably depending on the location. The highest incidence of macrolide resistance in Streptococcus pneumoniae is found in Japan, where 80–100% of pneumococci have been found to be macrolide resistant [119,123]. In contrast, resistance rates in Scandinavia (Norway and Sweden) are remarkably low, i.e.…”