THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 NTT
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1 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS ,866 JA
2 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 NTT
3 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS
4 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June ,866 FQs 30 Streptococcus pyogenes Streptococcus pneumoniae Moraxella catarrhalis Haemophilus in uenzae FQs S. pneumoniae S. pyogenes H. in uenzae - H. in uenzae % % % %FQs Escherichia coli levo oxacin LVFX 29.3% LVFX % % % % % 2009 LVFX 500 mg 1 1 Klebsiella pneumoniae FQs E. coli Staphylococcus aureus MRSA FQs sita oxacin 51.6% FQs 10% S. aureus % staphylococcifqs staphylococci MRSA Pseudomonas aeruginosa FQs % % P. aeruginosa 2.3% 0.3% 2007 Acinetobacter spp. FQs Acinetobacter baumannii imipenem 2.4% 13 Neisseria gonorrhoeae FQs % Ceftriaxone CTRX % CTRX 17 FQs staphylococci Enterococcus faeciump. aeruginosa N. gonorrhoeae E. coli 20% % E. coli 70% 80% Staphylococcus aureus MRSA 1 - Extended-spectrum
5 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS lactamase: ESBL Escherichia coli Klebsiella pneumoniae 2 - MBL 3 DNA 4 Pharmacokinetics/ Pharmacodynamics PK-PD PK-PD FQs FQs FQs 1992 FQs FQs 5 7 FQs E. coli 2000 FQs FQs ESBL Table 1. The number of isolates.
6 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June , ,866 Table 1 Table BML 80 C Table 2. List of the levo oxacin surveillance group.
7 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS Levo oxacin LVFX cipro oxacin CPFX tosufloxacin TFLX sitafloxacin STFX benzylpenicillin PCG ampicillin ABPC clavulanic acid amoxicillin CVA/AMPC piperacillin PIPC oxacillin MPIPC cefaclor CCL cefotiam CTM cefdinir CFDN cefpodoxime CPDX ceftazidime CAZ cefotaxime CTX ceftriaxone CTRX cefpirome CPR meropenem MEPM panipenem PAPM imipenem IPM aztreonam AZT minocycline MINO clarithromycin CAM azithromycin AZM vancomycin VCM sulfamethoxazole trimethoprim ST gentamicin GM amikacin AMK linezolid LZD chloramphenicol CP 3. MIC Neisseria gonorrhoeae MIC Table 3 Clinical and Laboratory Standards Institute CLSI 8 MIC Streptococcus pneumoniae S. pneumoniae PSSP PCG MIC 0.06 g/ml S. pneumoniae PRSP PCG MIC 2.0 g/ ml CLSI 4. Haemophilus in uenzae - Haemophilus in uenzae - 5. QRDR Table 4 QRDR 9 LVFX MIC 20% 20 MIC 20 LVFX MIC 10 MIC Extendedspectrum -lactamase: ESBL E. coli K. pneumoniae Proteus mirabilis CTX CVA CAZ CVA MIC CTX CAZ MIC 3 ESBL PCR ESBL 7. Pseudomonas aeruginosa MDRP P. aeruginosa MIC CPFX 4.0 g/ml IPM 16 g/ml AMK 32 g/ml MDRP 8. Acinetobacter baumannii A. baumannii VITEK2 Sysmex
8 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 Table 3. Test drugs and the range of their concentrations for determination of MIC.
9 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS Table 4. Target species and genes of QRDR measurement. Table 5. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI Table 5 Table 8 Streptococcus pyogenes CPFX 81.6% MINO 84.8% CAM 56.0% AZM 55.1% 98% Table 5 STFX FQs 5 15 QRDR %QRDR parc LVFX MIC g/ml
10 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 Table 6. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI parc 2 gyra parc MIC 0.5 g/ml 42 1 parc MIC 0.25 g/ml 20 1 MIC g/ml 8 2 parc LVFX 2 S. pneumoniae FQs CPFX 80.2% 98% MIC g/ml STFX MIC g/ml Table 5 QRDR LVFX 10 QRDR gyra parcgyra pare 5 LVFX 145 MIC 2.0 g/ml 12 gyra parc pare 4 MIC 1.0 g/ml 90 parc 1 MIC 0.5 g/ml QRDR FQs VCM CVA/AMPC CTRX PAPM 100% 99.5% 97.4% 98.2% IPM 79.0% % 80%
11 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS Table 7. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI. Table 5 PSSP PISP PRSP 48.0% 43.4% 8.6% PRSP CTRX 1.8% CCL 100% CTM 98.2% CFDN 98.2% CPDX 91.2% S. aureus MSSA FQs MIC g/ml % STFX FQs 90%ABPC 43.2% CAM 75.3% AZM 74.8% 80% Table 6 FQs MRSA MIC 90 STFX 8.0 g/ml 16 g/ml 64 g/ml FQs STFX 51.6% 10% % FQs VCM LZD % VCM LZD Table 6 VCM MRSA MIC 2.0 g/ ml MRSA CA-MRSA - LVFX CAM MINO % staphylococci
12 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 Table 8. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI. FQs MIC g/ml FQs CAM 76.7% AZM 75.9% % FQs MSSA STFX % Table 7 staphylococci MIC 90 MRSA STFX MIC g/ml MINO 96.7% FQs MIC g/ml % VCM LZD Table 7 Enterococcus faecalis FQs % 100% ABPC VCM Table 8 Enterococcus faecium VCM 99.8% LZD 98.0% MINO 50.8% STFX 30.5% 15% Table 8 2 Table 9 Moraxella catarrhalis FQs MIC g/ml LVFX, CPFX, STFX
13 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS Table 9. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI. ABPC 15.5% CVA/AMPC - CTM 88.7% 95% N. gonorrhoeaefqs MIC 90 LVFX, CPFX, TFLX g/ml STFX 0.5 g/ml FQs MIC 90 CTRX 0.25 g/ml AZM 2.0 g/ml CFDN 1.0 g/ml MINO 1.0 g/ml CAM 4.0 g/ ml ABPC 4.0 g/ml CVA/AMPC 4.0 g/ ml ABPC CVA/AMPC CTRX4 5.0% 4 3 Table 10 Table 15 E. coli FQs MIC 90 STFX 1.0 g/ml g/ml STFX 91.9% % 30% % Table 10 LVFX gyra parc LVFX QRDR MIC g/ml % gyra gyra 0.5 g/ml g/ml 3 parc
14 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 Table 10. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI g/ml QRDR ESBL % K. pneumoniae FQs MIC g/ml FQs % E. coli Table 10 E. coli LVFX QRDR MIC g/ml % gyra % QRDR gyra parc MIC 16 g/ml ESBL29 4.3% Citrobacter spp. Enterobacter spp. FQs MIC g/ml g/ mlfqscitrobacter spp % Enterobacter spp % Citrobacter spp. PAPM 99.8% IPM 96.5% Enterobacter spp. PAPM 93.6% IPM 86.8% Table 11 P. mirabilis FQs MIC 90 STFX 1.0 g/ml FQs g/ml % MINO 2.0% ST CP 60.7% 67.1% FQs Table 12 ESBL % Proteus FQs MIC g/ml %
15 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS Table 11. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI. FQs CAZ, CTX, CPDX 80% Table 12 Serratia marcescens FQs MIC g/ml % CAZ PAPM 98.3% 97.8% Table 13 Salmonella spp. FQs MIC g/ml 100% FQs ST 90% Table 13 H. in uenzae FQs MIC g/ml Table 14 STFX FQs LVFX gyra MIC g/ml; 9.2% 0.03 g/ml; 17.4% 0.06 g/ml; 60.0% g/ ml; 69.2% - BLNAR H. in uenzae % %CFDN - BLPAR % CVA/AMPC CVA/ AMPC MIC 8.0 g/ml 23 Acinetobacter spp. FQs MIC g/ml % IPM, MINO, PAPM, CAZ 96.9%, 96.5%, 95.0%, 89.8%
16 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 Table 12. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI. 50% Table 14 IPM % PAPM % IPM A. baumannii P. aeruginosa FQs MIC g/ml % FQs STFX 80.0% 80% AMK 96.4% PIPC 93.3% GM 89.7% CAZ 86.0% MEPM 85.9% P. aeruginosa FQs MIC g/ ml % FQs AMK 98.3% GM 94.4% PIPC 92.7% Table 15 CPFX IPM AMK MDRP 2.3% 140.3% 2 MDRP % 10 50% 1 S. pyogenes FQs CPFX 81.6% 98% M N DNA
17 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS Table 13. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI. emm 10 prtf1-11 S. pyogenes LVFX 6 2 FQs S. pneumoniae 52.0% 2007 CAM, AZM 85% 12,13 ermb 23S RNA mefa ermb MIC ermb mefa
18 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 Table 14. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI. 14 S. pneumoniae 15 S. pneumoniae FQs CPFX 19.8%1.5% FQs DNA IV QRDR LVFX QRDR MIC 2.0 g/ml 12 gyra parc pare 4 MIC 1.0 g/ml 90 parc 1 CLSI LVFX MIC 2.0 g/ml parc 17 QRDR FQs CPFX MIC LVFX FQs 18 FQs 19 FQs MSSA FQs 88% MRSA FQs
19 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS Table 15. In vitro activities of drugs against clinical isolates and percentages of isolates susceptible to test drugs on the basis of CLSI VCM VCM MRSA MIC 2.0 g/ml % % % VCM MIC 2.0 g/ml VCM VanA MRSA FQs E. coli FQs E. coli FQs % LVFX % % % % % % % % LVFX 500 mg 1 1 C max 1C max LVFX 61.6% 76.3%66.0%77.2% % 18% 21 MIC parc FQs E. coli
20 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 FQs K. pneumoniae FQs E. coli K. pneumoniae FQs 22 E. coli LVFX QRDR E. coli, K. pneumoniae, P. mirabilis CFDN % CFDN ESBL PCR E. coli % K. pneumoniae % P. mirabilis % ESBL 2007 E. coli % K. pneumoniae % P. mirabilis % ESBL 23 E. coli P. mirabilis E. coli ESBL 2007 FQs ESBL E. coli % K. pneumoniae % P. mirabilis % LVFX ESBL LVFX 2007 ESBL E. coli ST131 FQs H. in uenzae BLPAR BLNAR BLPAR BLNAR 24 BLNAR BLPAR 6 H. in uenzae BLNAR CFDN H. in uenzae - PBPs BLNAR FQs 98% QRDR FQs 25 LVFX MIC g/ml gyra g/ml; 9.2%, 0.03 g/ml; 13.0%, 0.06 g/ml; 60.0%, g/ ml; 61.5% FQs P. aeruginosa FQs 8 FQs P. aeruginosa FQs MDRP 26 MDRP 2.3% 140.3% 2
21 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS MDRP MDRP % % 1 Acinetobacter spp. 95% 15 Acinetobacter spp. 13 A. baumannii IPM N. gonorrhoeae CTRX 2007 CTRX4 5.0% 4 CTRX 17 FQs staphylococci E. faeciump. aeruginosa, N. gonorrhoeae, E. coli 20% % E. coli 70% 80% 1 MINE, Y.; W. HIGUCHI, K. TAIRA, et al.: Nosocomial outbreak of multidrug-resistant USA300 methicillin-resistant Staphylococcus aureus causing severe furuncles and carbuncles in Japan. J. Dermatol. 38: , FOUQUET, M.; V. MORANGE & F. BRUYÈRE: Five years following of infections with extendedspectrum beta-lactamase producing enterobacteriaceae. Prog. Urol. 22: 17 21, HIRAKATA, Y.; K. IZUMIKAWA, T. YAMAGUCHI, et al.: Rapid detection and evaluation of clinical characteristics of emerging multiple-drugresistant Gram-negative rods carrying the metallo- -lactamase gene bla IMP. Antimicrob. Agents Chemother. 42: , I 92: , YAMAGUCHI, K.; A. OHNO & Levo oxacin Surveillance Group: Investigation of the susceptibility trends in Japan to fluoroquinolones and other antimicrobial agents in a nationwide collection of clinical isolates: a longitudinal analysis from 1994 to Diagn. Microbiol. Infect. Dis. 52: , ,639 Jpn. J. Antibiotics 59: , ,919 Jpn. J. Antibiotics 62: , Clinical and Laboratory Standards Institute: Performance standards for antimicrobial susceptibility testing; Twenty-First informational Supplement M100-S21. Wayne, PA, GERISCHER, U.: Direct sequencing of DNA produced in a polymerase chain reaction. Meth. Mol. Biol. 167: 53 61, PIRES, P.; D. ROLO, A. MORAIS, et al.: Description of macrolide-resistant and potential virulent clones of Streptococcus pyogenes causing asymptomatic colonization during in the Lisbon area. Eur. J. Clin. Microbiol. Infect.
22 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 Dis.: published online, SELA, S. & A. BARZILAI: Why do we fail with penicillin in the treatment of group A Streptococcus infections? Ann. Med. 31: , FELMINGHAM, D.; R. R. REINERT, Y. HIRAKATA, et al.: Increasing prevalence of antimicrobial resistance among isolates of Streptococcus pneumoniae from the PROTEKT surveillance study, and comparative in vitro activity of the ketolide, telithromycin. J. Antimicrob. Chemother. 50: 25 37, SONG, J. H.; S. I. JUNG, K. S. KO, et al.: High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia an ANSORP study. Antimicrob. Agents Chemother. 48: , FARRELL, D. J.; S. G. JENKINS, S. D. BROWN, et al.: Emergence and spread of Streptococcus pneumoniae with erm B and mef A resistance. Emerg. Infect. Dis. 11: , NIEDERMAN, M. S.; J. B. JR. BASS, G. D. CAMPBELL, et al.: Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. American Thoracic Society. Medical Section of the American Lung Association. Am. Rev. Respir. Dis. 148: , WEIGEL, L. M.; G. J. ANDERSON, R. R. FACKLAM, et al.: Genetic analyses of mutations contributing to uoroquinolone resistance in clinical isolates of Streptococcus pneumoniae. Antimicrob. Agents Chemother. 45: , SUE, L.; B. DARRIN, M. ALLISON, et al.: Antimicrobial susceptibility breakpoints and rst-step parc mutations in Streptococcus pneumoniae: redefining fluoroquinolone resistance. Emerg. Infect. Dis. 9: , PIDDOCK, L. J.; M. JOHNSON, V. RICCI, et al.: Activities of new uoroquinolones against fluoroquinolone-resistant pathogens of the lower respiratory tract. Antimicrob. Agents Chemother. 42: , ICIAR, R. A.; R. BELÉN, R. ESTHER, et al.: Clonal spread of levo oxacin-resistant Streptococcus pneumoniae invasive isolates in Madrid, Spain, 2007 to Antimicrob. Agents Chemother. 55: , REINERT, R. R.; D. E. LOW, F. ROSSI, et al.: Antimicrobial susceptibility among organisms from the Asia/Paci c Rim, Europe and Latin and North America collected as part of TEST and the in vitro activity of tigecycline. J. Antimicrob. Chemother. 60: , HSUEH, P. R.; D. J. HOBAN, Y. CARMELI, et al.: Consensus review of the epidemiology and appropriate antimicrobial therapy of complicated urinary tract infections in Asia- Paci c region. J. Infect. 63: , LEE, K.; M. A. LEE, C. H. LEE, et al.: Increase of ceftazidime- and fluoroquinolone-resistant Klebsiella pneumoniae and imipenem-resistant Acinetobacter spp. in Korea: analysis of KONSAR study data from 2005 and Yonsei Med. J. 51: , KOMATSU, M.; M. AIHARA, K. SHIMAKAWA, et al.: Evaluation of MicroScan ESBL con rmation panel for Enterobacteriaceae-producing, extended-spectrum beta-lactamases isolated in Japan. Diagn. Microbiol. Infect. Dis. 46: , TRISTRAM, S.; M. R. JACOBS & P. C. APPELBAUM: Antimicrobial resistance in Haemophilus in uenzae. Clin. Microbial. Rev. 20: , KIM, I. S.; N. Y. LEE, S. KIM, et al.: Reduced levo oxacin susceptibility in clinical respiratory isolates of Haemophilus in uenzae is not yet associated with mutations in the DNA gyrase and topoisomerase II genes in Korea. Yonsei Med. J. 52: , TAKEYAMA, K.; Y. KUNISHIMA, M. MATSUKAWA, et al.: Multidrug-resistant Pseudomonas aeruginosa isolated from the urine of patients with urinary tract infection. J. Infect. Chemother. 8: 59 63, 2002
23 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS In vitro susceptibilities to levo oxacin and various antibacterial agents of 12,866 clinical isolates obtained from 72 centers in 2010 KEIZO YAMAGUCHI Department of Advanced and Integrated Analysis of Infectious Diseases, Toho University School of Medicine AKIRA OHNO, YOSHIKAZU ISHII and KAZUHIRO TATEDA Department of Microbiology and Infectious Diseases, Toho University School of Medicine MORIHIRO IWATA Department of Clinical Laboratory, Toho University Omori Medical Center and Levo oxacin Surveillance Group KOUJI AKIZAWA and CHIKARA SHIMIZU Hokkaido University Hospital TASUKU HAYASHI Muroran City General Hospital Asahikawa City Hospital MITSUO KAKU, HIROYUKI KUNISHIMA and MIHO KITAGAWA Tohoku University Graduate School of Medicine MAKOTO MIKI Japanese Red Cross Sendai Hospital CHIZUKO KAWAMURA Aomori Prefectural Central Hospital MINORU YASUJIMA Hirosaki University School of Medicine & Hospital HIROMI TASHIRO, HIROKO HORIUCHI and YOSEI KATAYAMA Hachinohe City Hospital AKIRA SUWABE and MAKIKO KUROTA Iwate Medical University Hospital KENJI KIKUCHI and SATORU KUROKI Yuri-Kumiai General Hospital KATSU HIRAYAMA, TOSHIAKI TAKAHASHI and TAKANORI GOTOU JA Akita Kouseiren Hiraka General Hospital KEITA MORIKANE and REIKO OTA Yamagata University Hospital TAKUO NAKAGAWA Kozirakawa Shiseidou Hospital KYOJI MORIYA The University of Tokyo MITSURU MURATA Keio University School of Medicine AKIKO YONEYAMA Toranomon Hospital SHIGEMI KONDOU and SHIGEKI MISAWA Juntendo University School of Medicine IMAO SEKINE and JOJI SHIOTANI The Cancer Institute Hospital of JFCR TOMOHIRO NAKAYAMA and MICHIKO YAGOSHI Nihon University Itabashi Hospital HAJIME HORIUCHI and YOKO TAZAWA NTT Medical Center Tokyo
24 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 HARUSHIGE KANNO and MASANORI AIHARA Takane Hospital KENICHIRO YAMAZAKI Saitama Red Cross Hospital HIDEYUKI OKAMOTO Kawaguchi Municipal Medical Center KOSUKE HARUKI, JUNKO YAZAWA and EIKO NAGANO Dokkyo Medical University, Koshigaya Hospital MOTOI OKADA, YASUKO FUKUDA and HIROMI IKARI Koshigaya Municipal Hospital SHIGEFUMI MAESAKI and GIICHI HASHIKITA Saitama Medical University Hospital MIDORI SUMITOMO Yokohama City University Hospital EIJI MIYAJIMA Yokohama City University Medical Center TAKEFUMI SAITO Ibarakihigashi National Hospital NOBUYUKI TANIGUCHI Jichi Medical School AKIRA HISHINUMA, YOSHITAKA YAMAMOTO and YUKI OKAMOTO Dokkyo Medical University Hospital NOBUO YAMANE, RYOU MARUYAMA and CHIEKO KAWASHIMA Ashikaga Red Cross Hospital MASAMI MURAKAMI, SACHIE YOMODA and TETSUO MACHIDA Gunma University Hospital YUKIO OZAKI and TAKASHI UCHIDA University of Yamanashi Hospital HISASHI BABA Nagoya University Hospital YASUYUKI SUGIURA, KONOMI KONDO and TAKAKO YAMADA Aichi Prefectural Welfare Federation of Agricultural Co-operative Associations Anjo-kosei Hospital HIDEO GONDA and IKUO YAMAGUCHI Toyohashi Municipal Hospital TOSHIYUKI AKAHORI and KEIICHI UEMURA Fukuroi Municipal Hospital MASATO MAEKAWA Hamamatsu University School of Medicine HITOSHI YOSHIMURA Mie Prefectural Shima Hospital KANAME NAKATANI, YOSHIKO MATSUSHIMA and TSUTOMU NOBORI Mie University Hospital YOSHINORI FUJIMOTO, YUKO ASANO and ASAMI MORINAGA Ogaki Municipal Hospital SHINICHI FUJITA and YASUKO SENDA Kanazawa University Hospital YUKIO HIDA, MASANORI YAMASHITA and HARUYOSHI YOSHIDA University of Fukui Hospital SATOSHI ICHIYAMA Kyoto University Hospital HIDETOSHI OKABE, MASAYO SHIGETA and KAORU SHIMIZU Shiga University of Medical Science HIROYA MASAKI, HITOSHI HEIJYOU and HIDEO NAKAYA Kansai Medical University Takii Hospital TAKAYUKI TAKUBO, TADASHI KUSAKABE and TOMONORI HIGASHIYAMA Osaka Medical College Hospital HIROKO YOSHIDA and HIROSHI MORISHITA Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
25 June 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS SHUJI MATSUO, HISASHI KONO and SAORI FUKUDA Tenri Hospital REIKO SANO Nara Medical University Hospital YOSUKE YUZUKI, NORIO IKEDA and MASAYA IDOMUKI Japanese Red Cross Society Wakayama Medical Center GO YAMAMOTO Nishi-kobe Medical Center SYOHIRO KINOSHITA and SEIJI KAWANO Kobe University Hospital MASAO DOI, YAEKO WATANABE and SATOMI SHIMIZU Hirosima Prefectural Hospital MIKIO OKA and YOSHIHIRO KOBASHI Kawasaki Medical School NOBUCHIKA KUSANO Okayama University Hospital HIROMITSU FUJIWARA, HIROMI MUROTA and SHOTA MORISHITA Tottori University Hospital ATSUSHI NAGAI, HIDEHIKO MORIYAMA and YUKI TANIGUCHI Shimane University Hospital KIYOSHI NEGAYAMA and KOJI MURAO Kagawa University Hospital HITOSHI MIYAMOTO Ehime University Hospital TETSURO SUGIURA and TAMAE MORITA Kochi Medical School Hospital HIROMI TOU and AKIRA MATSUNAGA Fukuoka University Hospital DONGCHON KANG and MAKIKO KIYOSUKE Kyushu University Graduate School of Medical Sciences KOICHI MASHIBA Kitakyushu Municipal Medical Center KATSUNORI YANAGIHARA, JUNICHI MATSUDA and SHIGERU KOHNO Nagasaki University Hospital YOSUKE AOKI, ZENZO NAGASAWA and KOJI KUSABA Saga Medical School Hospital KAZUFUMI HIRAMATSU and TETSUNORI SAIKAWA Oita University Hospital HIROAKI MIYANOHARA Kagoshima University Hospital YUJI SAEKI, ICHIRO TAKAJO and AKIHIKO OKAYAMA University of Miyazaki Hospital NOBUHISA YAMANE and ISAMU NAKASONE Clinical Laboratories, University Hospital of the Ryukyus Postmarketing surveillance of levo oxacin LVFX has been conducted continuously since The present survey was performed to investigate in vitro susceptibility of recent clinical isolates in Japan to 30 selected antibacterial agents, focusing on uoroquinolones FQs. The common respiratory pathogens Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae continue to show a high susceptibility to FQs. In contrast, widely-prevailing resistance to macrolides was markedly noted among S. pneumoniae and S. pyogenes. Regarding H. in uenzae, the prevalence of -lactamase-negative ampicillinresistant isolates has been increasing year by year 25.8% in 2002, 40.0% in 2004, 50.1% in 2007, and 57.9% in Enterobacteriaceae showed high susceptibility to FQs, however,
26 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 3 June 2012 prevalence of LVFX-resistant Escherichia coli, including intermediate resistance, was 29.3%, showing an increase over time. Nevertheless, the increase in the prevalence of LVFX-resistant E. coli isolates has slowed since % in 2000, 11.8% in 2002, 18.8% in 2004, 26.2% in 2007, and 29.3% in 2010, suggesting the in uence of LVFX 500 mg tablets since its approval in Another Enterobacteriaceae member, Klebsiella pneumoniae, showed low resistance to FQs, in contrast with E. coli. In methicillin-resistant Staphylococcus aureus MRSA, the percentage of FQ-susceptible isolates was low, at 51.6% for susceptibility to sita oxacin, and at only around 10% for susceptibility to other FQs. However, methicillin-susceptible S. aureus MSSA isolates were highly susceptible to FQs, with the percentage ranging from 88.5% to 99.1%. The prevalence of FQs-resistant isolates in methicillin-resistant coagulase-negative staphylococci was higher than that in methicillin-susceptible coagulase-negative staphylococci, although it was lower than the prevalence of FQ-resistance in MRSA. The prevalence of FQsresistant Pseudomonas aeruginosa isolates derived from urinary tract infections UTIs was %, higher than the prevalence of % in P. aeruginosa isolates from respiratory tract infections RTIs. While this trend was consistent with the results of previous surveillance, gradual decreases were noted in the prevalence of FQ-resistant P. aeruginosa isolates derived from UTIs. The prevalence of multidrug-resistant P. aeruginosa was 2.3% among isolates derived from UTIs and 0.3% among isolates from RTIs, a decrease from the results of Acinetobacter spp. showed high susceptibility to FQs. Imipenem-resistant Acinetobacter baumannii, which is currently an emerging issue, was detected at a prevalence of 2.4% 13 isolates. Neisseria gonorrhoeae showed a high resistance of %, to FQs. Ceftriaxone CTRX continued to show 100% susceptibility until 2007, but the present survey revealed the advent of resistance to CTRX in some clinical isolates. The result of the present survey indicated that although methicillin-resistant staphylococci, Enterococcus faecium, P. aeruginosa from UTIs, N. gonorrhoeae, and E. coli showed resistance of about 20% or more % against the FQs which have been used clinically for over 17 years, the trends observed were similar to the results of previous surveillance. While FQ resistance has been prevailing in E. coli, E. coli still shows more than 70% susceptibility to FQs. The other bacterial species maintained high susceptibility rates of greater than 80%, against FQs.
2 2 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 1 Feb Neisseria gonorrhoeae ceftriaxone CTRX % 2010 CTRX 20 FQ staphylococci, E. faecium, N.
Feb. 2016 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 1 1 1 2013 69 11,762 2015 11 16 1994 2013 69 19 11,762 FQ 33 Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae
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