THE JAPANESE JOURNAL OF ANTIBIOTICS ( 37 ) methicillin-susceptible Staphylococcus aureus (MSSA) Escherichia coli levof

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1 242 ( 36 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 prulifloxacin * ** ** CMC * ** Prulifloxacin ulifloxacin (UFX)

2 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 37 ) methicillin-susceptible Staphylococcus aureus (MSSA) Escherichia coli levofloxacin (MSSA, MIC 2 m g/ml; E. coli, MIC 4 m g/ml) 0% 11.8% % UFX UFX E. coli MIC 90 levofloxacin 1/2 1/4 Klebsiella pneumoniae UFX MIC m g/ml 0.03 m g/ml Pseudomonas aeruginosa UFX Streptococcus pneumoniae 3 UFX MIC 90 Salmonella Shigella UFX 0.12 m g/ml Prulifloxacin (PUFX) ulifloxacin (UFX) 1,2) 3,4) PUFX methicillin-resistant Staphylococcus aureus (MRSA) PUFX UFX 1. Ulifloxacin UFX ofloxacin (OFLX Sigma-Aldrich Co.) levofloxacin (LVFX Sequoia Research Products Ltd.) ciprofloxacin (CPFX Sequoia Research Products Ltd.) gatifloxacin (GFLX Sequoia Research Products Ltd.) tosufloxacin (TFLX Sequoia Research Products Ltd.) 1/ mol NaOH 9/10 UFX OFLX LVFX CPFX GFLX 640 mg /ml TFLX 160 mg /ml

3 244 ( 38 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 Table 1. * ** Table , (MIC) Methicillin-susceptible S. aureus (MSSA) methicillin-susceptible Staphylococcus epidermidis (MSSE) Enterococcus faecalis Escherichia coli Enterobacter cloacae Enterobacter aerogenes Klebsiella pneumoniae Citrobacter freundii Serratia marcescens Proteus vulgaris Proteus mirabilis Salmonella spp. Shigella spp. Pseudomonas aeruginosa Tripticase Soy Agar (Nippon Becton Dickinson Co., Ltd.) 35 C Streptococcus pyogenes Streptococcus pneumoniae Moraxella catarrhalis Sheep Blood Agar (T) (Nippon Becton Dickinson Co., Ltd.) Haemophilus influenzae Chocolate II Agar (Nippon Becton Dickinson Co., Ltd.) 35 C 5 6% CO 2 18 Peptostreptococcus spp. GAM 35 C Mc- Farland 0.5 Difco TM Mueller- Hinton broth (MHB Becton, Dickinson and Company) 10 8 CFU/mL MHB CFU/ ml MSSA MSSE E. faecalis E. coli E. cloacae E. aerogenes K. pneumoniae C. freundii S. marcescens Shigella spp. Salmonella spp. P. aeruginosa Difco TM Mueller-Hinton agar (MHA Difco) P. vulgaris P. mirabilis MHB Bacto TM Agar (Becton, Dickinson and Company) 3% S. pyogenes S. pneumoniae M. catarrhalis 5% MHA H. influenzae 80 C MHA 5% Peptostreptococcus spp. GAM 2

4 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 39 ) UFX OFLX LVFX CPFX GFLX mg/ml 64 mg/ml TFLX mg/ ml 16 mg/ml 10 4 CFU/spot MSSA E. coli E. cloacae E. aerogenes K. pneumoniae C. freundii S. marcescens P. vulgaris P. mirabilis Shigella spp. Salmonella spp. P. aeruginosa 35 C 18 E. faecalis 35 C 20 MSSE 35 C 24 S. pyogenes S. pneumoniae H. influenzae M. catarrhalis 5 6% CO 2 35 C 18 Peptostreptococcus spp. 35 C 42 MIC 1. 2,202 (Table 2) MSSA S. pneumoniae E. aerogenes S. marcescens P. aeruginosa E. faecalis E. coli C. freundii P. vulgaris P. mirabilis S. pyogenes M. catarrhalis H. influenzae MSSE Salmonella spp. Shigella spp. Peptostreptococcus spp. E. cloacae K. pneumoniae MSSE MIC 50%MIC (MIC 50 ) 90%MIC (MIC 90 ) Table 3 4 (1) (Table 3) MSSA UFX MIC mg/ml MIC mg/ml 2 2 mg/ml 3 8 mg/ml UFX TFLX GFLX S. pyogenes E. faecalis UFX MIC 90 1 mg/ml 64 mg/ml S. pneumoniae UFX MIC 50 MIC mg/ml MIC (LVFX MIC: 8 mg/ml) 1 MSSE 2 UFX MIC 90 8 mg/ml MSSA mg/ml MSSA UFX LVFX CPFX OFLX (2) (Table 4) E. coli UFX MIC mg/ml 2 4 mg/ml 3 8 m g/ml P. mirabilis E. coli 3 MIC K. pneumoniae UFX MIC m g/ml m g/ml mg/ml P. aeruginosa 2

5 246 ( 40 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 *: methicillin-susceptible Table 2.

6 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 41 ) Table 3. * UFX, ulifloxacin; OFLX, ofloxacin; LVFX, levofloxacin; CPFX, ciprofloxacin; GFLX, gatifloxacin; TFLX, tosufloxacin. ** NA: not available

7 248 ( 42 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 Table 4. * UFX, ulifloxacin; OFLX, ofloxacin; LVFX, levofloxacin; CPFX, ciprofloxacin; GFLX, gatifloxacin; TFLX, tosufloxacin.

8 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 43 ) Table 4. * UFX, ulifloxacin; OFLX, ofloxacin; LVFX, levofloxacin; CPFX, ciprofloxacin; GFLX, gatifloxacin; TFLX, tosufloxacin.

9 250 ( 44 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 Table 5. Salmonella * UFX, ulifloxacin; OFLX, ofloxacin; LVFX, levofloxacin; CPFX, ciprofloxacin; GFLX, gatifloxacin; TFLX, tosufloxacin. Table 6. Peptostreptococcus * UFX, ulifloxacin; OFLX, ofloxacin; LVFX, levofloxacin; CPFX, ciprofloxacin; GFLX, gatifloxacin; TFLX, tosufloxacin. 3 MIC 90 1 E. cloacae S. marcescens P. vulgaris H. influenzae UFX E. aerogenes C. freundii M. catarrhalis UFX 3 1 mg/ml MIC 1 3. Salmonella Shigella Peptostreptococcus Salmonella spp. Shigella spp. Peptostreptococcus spp. UFX Salmonella spp. 36 UFX CPFX MIC m g/ml GFLX TFLX OFLX LVFX (Table 5) Shigella spp. UFX mg/ml Peptostreptococcus spp. 21 UFX TFLX MIC 50 MIC mg/ml (Table 6)

10 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 45 ) PUFX UFX UFX MSSA E. coli P. mirabilis UFX MIC 90 1 P. mirabilis MSSA E. coli LVFX CLSI MSSA (MIC 2 mg/ml) 0% 7.9% 11.8% E. coli (MIC 4 mg/ml) 14.6% 19.0% 20.8% ) ) ) MSSA LVFX 4.7% 5.5% 6.8% 3 LVFX MSSA E. coli 3 LVFX 1 MSSA Table 7. Levofloxacin E. coli E. coli 8,9) LVFX E. coli 15 (25.0%) (36.4%) (18.5%) (Table 7) E. coli E. coli 9) K. pneumoniae E. coli E. coli 10,11) P. aeruginosa LVFX (MIC 4 mg/ml)

11 252 ( 46 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ % % % P. aeruginosa 12,13) imipenem CPFX 40% 54 19) P. aeruginosa P. aeruginosa UFX P. aeruginosa 3,4) 1 S. pneumoniae UFX MIC: 32 mg/ml S. pneumoniae 14) 1% 7) S. pneumoniae M. catarrhalis MIC E. coli E. cloacae S. marcescens H. influenzae UFX UFX E. aerogenes C. freundii UFX MIC Salmonella spp. OFLX GFLX MORITA et al. 15) 17% GyrA 83 MIC 16,17) Peptostreptococcus spp. 21 GFLX 2 UFX UFX PUFX (94.9%) (87.0%) 18)

12 THE JAPANESE JOURNAL OF ANTIBIOTICS ( 47 ) 1) YOSHIDA, T. & S. MITSUHASHI : Antibacterial activity of NM394, the active form of prodrug NM441, a new quinolone. Antimicrob. Agents Chemother. 37: , ) NM441 in vitro in vivo 44(Sl): 26 41, ) prulifloxacin in vitro Jpn. J. Antibiotics 55: , ) Prulifloxacin NM394 Staphylococcus aureus, Escherichia coli Pseudomonas aeruginosa in vitro Jpn. J. Antibiotics 55: , ) ,475 Jpn. J. Antibiotics 58: 17 44, ) ,639 Jpn. J. Antibiotics 59: , ) ,571 Jpn. J. Antibiotics 62: , ) MURATANI, T. & T. MATSUMOTO: Bacterial resistance to antimicrobials in urinary isolates. Int. J. Antimicrob. Agents 24 (Suppl. 1): S28 31, ) BOYD, L. B.; R. L. ATMAR, G. L. RANDALL, et al.: Increased fluoroquinolone resistance with time in Escherichia coli from 17,000 patients at a large county hospital as a function of culture site, age, sex, and location. BMC Infect. Dis. 15; 8: 4, ) b- 54: , ) ROONEY, P. J.; M. C. O LEARY, A. C. LOUGHREY, et al. : Nursing homes as a reservoir of extended-spectrum b-lactamase (ESBL)-producing ciprofloxacin-resistant Escherichia coli. J. Antimicrob. Chemother. 64: , ) 21: , ) 22: , ) INOUE, M.; N. Y. LEE, S. W. HONG, et al.: PROTEKT : a multicentre study of the antibiotic susceptibility of respiratory tract pathogens in Hong Kong, Japan and South Korea. Int. J. Antimicrob. Agents 23: 44 51, ) MORITA, M.; K. HIROSE, N. TAKAI, et al. : Salmonella enterica serovar Typhi in Japan, : emergence of high-level fluoroquinolone-resistant strains. Epidemiol. Infect. 27: 1 4, ) CHAU, T. T.; J. I. CAMPBELL, C. M. GALINDO, et al.: Antimicrobial drug resistance of Salmonella enterica serovar typhi in asia and molecular mechanism of reduced susceptibility to the fluoroquinolones. Antimicrob. Agents Chemother. 51: , ) GRIGGS, D. J.; K. GENSBERG & L. J. PIDDOCK: Mutations in gyra gene of quinolone-resistant Salmonella serotypes isolated from humans and animals. Antimicrob. Agents Chemother. 40: , ) Prulifloxacin 53: , 2008

13 254 ( 48 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 Susceptibility surveillance of clinical isolates to fluoroquinolone antimicrobial agents from 2003 to 2008: Post-marketing study of prulifloxacin SHIN KAWAI Department of General Medicine, Kyorin University School of Medicine ATSUSHI YOSHIDA Division of Infection Control, Clinical Laboratory Medicine, Dokkyo Medical University Hospital MITSUHIRO OKAZAKI Clinical Laboratory Medicine, Kyorin University Hospital YOSHITO TSUJIHARA Clinical Laboratory, Kanagawa Prefectural Shiomidai Hospital KAZUHISA INUZUKA Department of Clinical Laboratory, Anjo Kosei Hospital KAZUHIDE TAKEUCHI Department of Clinical Laboratory, Osaka City University Hospital NAOKO YAMASHITA Department of Clinical Laboratory, Japan Seafarers Relief Association Kobe Ekisaikai Hospital MAKOTO ONODERA Clinical Support Department, Hiroshima University Hospital TORU HIRAISHI*, TAKASHI IDA**, KAZUNORI MAEBASHI** * Chemistry, Manufacturing & Control Research Laboratories, ** Pharmaceutical Research Center, Meiji Seika Kaisha, Ltd. Yearly changes in the susceptibility of clinical isolates to ulifloxacin (UFX) and other fluoroquinolones were examined through surveys over 3 periods. In the first survey, 534 strains derived from 19 species were collected from clinical specimens during 6 months from December 2003 to May In the same way, 805 strains were collected from December 2005 to May 2006 in the second survey, and 863 strains were from December 2007 to May 2008 in the third survey. Over these 3 study periods, the susceptibilities of fluoroquinolones against methicillin-susceptible Staphylococcus aureus and Escherichia coli were decreased. The isolation frequency of levofloxacinnonsusceptible strain was increased from 0% to 11.8% and from 14.6% to 20.8%, respectively. MIC 90 s of UFX against these pathogens were also increased, but its MIC 90 for E. coli was 2 to 4 times lower than that of levofloxacin. On the other hand, the susceptibility of strains of Klebsiella pneumoniae to UFX was increased. Among the fluoroquinolones tested, UFX showed the most potent activity against Pseudomonas aeruginosa, and no changes in the MIC 90 s occurred during the surveillance. Although one strain of Streptococcus pneumoniae isolated in the third study period showed levofloxacin-resistance (MIC, 8 mg/ml), there were nearly no changes in the MIC 90 s of any agents tested including UFX against S. pneumoniae during the surveillance. As for other bacterial species, a tendency to increase in resistance to UFX was not observed. The activity of UFX against Salmonella spp. and Shigella spp. was superior/equal to those of fluoroquinolones tested.

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