2 2 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb CLSI M100-S17benzylpenicillin PCG MIC 0.05 g/ml S. pneumoniae penicillin-susceptible S. pneumon

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1 Feb THE JAPANESE JOURNAL OF ANTIBIOTICS Streptococcus pneumoniae 377 penicillin-binding protein: PBP 2004 S. pneumoniae 160

2 2 2 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb CLSI M100-S17benzylpenicillin PCG MIC 0.05 g/ml S. pneumoniae penicillin-susceptible S. pneumoniae: PSSP g/ml S. pneumoniae penicillin-intermediate S. pneumoniae: PISP 1.56 g/ml S. pneumoniae penicillinresistant S. pneumoniae: PRSP PSSP % PISP % PRSP 49 13% PISP PRSP PRSP PBP gpssp % 1 gpisp % 3 gprsp % % mefa % ermb166 44% 45 12% PBP % % % % PRSP % MIC 90 imipenem, panipenem, garenoxacin; 0.1 g/ml, moxi oxacin; 0.2 g/ml, meropenem, tosufloxacin; 0.39 g/ml, amoxicillin, clavulanic acid/ amoxicillin, cefditoren, cefcapene; 0.78 g/ml, PCG, piperacillin, cefteram, levo oxacin; 1.56 g/ml, cefotiam, flomoxef, pazufloxacin; 3.13 g/ml, cefdinir; 6.25 g/ml, nor oxacin, minocycline; 12.5 g/ml, clarithromycin; >100 g/ml 2004 Streptococcus pneumoniae - 1 2, S. pneumoniae S. pneumoniae 2004 I S. pneumoniae 377 5%Mueller Hinton MHA

3 Feb THE JAPANESE JOURNAL OF ANTIBIOTICS benzylpenicillin PCG Meiji Seika amoxicillin AMPC clavulanic acid/amoxicillin 1 : 14; CVA/ AMPC, CVA piperacillin PIPC cefteram CFTM cefditoren CDTR Meiji Seika cefcapene CFPN cefdinir CFDN: Sigma-Aldrich cefotiam CTM omoxef FMOX imipenem IPM: MSD meropenem MEPM panipenem PAPM garenoxacin GRNX tosu oxacin TFLX pazu oxacin PZFX moxi oxacin MFLX levo oxacin LVFX: Chem-Impex International norfloxacin NFLX: Sigma- Aldrichclarithromycin CAM: LKT Laboratories minocycline MINO 3. minimum inhibitory concentration: MIC 10 6 CFU/mL 8 5% MHA PCG CLSI M100-S17 9 PCG MIC 0.05 g/ml S. pneumoniae penicillin-susceptible S. pneumoniae: PSSP g/ml S. pneumoniae penicillin-intermediate S. pneumoniae: PISP 1.56 g/ml S. pneumoniae penicillin-resistant S. pneumoniae: PRSP 4. penicillin-binding protein: PBP mefa, ermb PRSPver. 2.0 PCR PBP 10 pbp1a, pbp2b, pbp2x 3 gpssp 1 gpisp 3 gprsp 5. II. 1. S. pneumoniae % 95 25% 69 18% 49 13% % %

4 4 4 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb PSSP PISP PRSP S. pneumoniae 377 PCG MIC 2004 Fig. 1 PSSP % PISP % PRSP 49 13% 2004 PSSP 30% 38% PRSP 19% 13% 1 PSSP PISP PRSP Table 1 PRSP 11 18% 4.1% PSSP 51% PSSP PRSP 2 PSSP PISP PRSP Table 2PRSP 32% Fig. 1. S. pneumoniae PCG MIC 2004 Table 1.PSSP PISP PRSP

5 Feb THE JAPANESE JOURNAL OF ANTIBIOTICS Table 2.PSSP PISP PRSP Table 3.PBP 9.0%, 8.5% 4.4% PRSP PRSP 4.2% 19% 3. PBP PBP Table gpssp % gpisp gprsp % % gprsp gprsp 73% 52% 28% 46% 4. Table mefa ermb % mefa % ermb % 45 12% PBP

6 6 6 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb Table % gprsp mefa ermb 40 11% % % % 73 19% PSSP % % % 3, 4, 7, 8, 10, 11, 14, 15, 18, 22, 23, 29, 31, PISP % % % % 7, 10, 11, 14, 21, 32, 33, 35 46PRSP % % 80% 4, 10, 16, 23, S. pneumoniae 377 PSSP 143 PISP 185 PRSP 49 MIC 50 MIC 90 Table MIC 90 AMPC CVA/AMPC 0.78 g/ml PCG PIPC 1.56 g/ml PRSP MIC 90 PSSP MIC 90 CDTR CFPN 0.78 g/ml CFTM 1.56 g/ml CTM FMOX 3.13 g/ml CFDN 6.25 g/ml CDTR CFPN PRSP MIC 90 PSSP 4 32 MIC 90 IPM PAPM 0.1 g/ml MEPM 0.39 g/ml PRSP MIC 90 PSSP 32 MIC 90 GRNX 0.1 g/ml MFLX 0.2 g/ml TFLX 0.39 g/ml LVFX 1.56 g/ml PZFX 3.13 g/ml NFLX 12.5 g/ml PSSP PISP PRSP MIC 50 MIC 90 CAM MIC 90 >100 g/ml MINO MIC g/ml MIC 50 MIC LVFX LVFX MIC: 12.5 g/ml 1

7 Feb THE JAPANESE JOURNAL OF ANTIBIOTICS Table 5. S. pneumoniae 377 MIC 50, MIC 90

8 8 8 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb Table 6. PSSP 143 MIC 50, MIC 90

9 Feb THE JAPANESE JOURNAL OF ANTIBIOTICS Table 7. PISP 185 MIC 50, MIC 90

10 10 10 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb Table 8. PRSP 49 MIC 50, MIC 90

11 Feb THE JAPANESE JOURNAL OF ANTIBIOTICS III. 4 7,11 14 S. pneumoniae S. pneumoniae S. pneumoniae 160 PISP PRSP 3 PCG % % % CLSI M100-S19 15 PCG MIC 1.56 g/ml PSSP 3.13 g/ml PISP 6.25 g/ml PRSP 4 1.1% PISP PRSP 10 gpisp gprsp 94% 2004 pbp2xmic PCG 16,17 pbp2x pbp2x MIC 50 gpssp MIC PCG PBP PCG PRSP % 9.0% 4.2% 19% S. pneumoniae 19F, 6B 23F , F, 6B 23F A MIC 50 MIC 90 MIC range 2004

12 12 12 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb PSSP PISP PRSPPISP PRSP MIC 90 PSSP PSSP PISP PRSP 2004 LVFX % % 7 LVFX % 3,24,25 LVFX LVFX MIC LVFX 12.5 g/ml GRNX 0.78 g/ml TFLX 1.56 g/ml MFLX 3.13 g/ml PZFX NFLX 50 g/mlgrnx PCG MIC 1.56 g/ml DNA GyrA, GyrB IV ParC, ParE quinolone resistance-determing region: QRDR 26 LVFX QRDR 27 ParC Ser-79 Tyr LVFX QRDR ,28,29 LVFX QRDR 1 6% 3 LVFX QRDR : NIKI, Y.; H. HANAKI, T. MATSUMOTO, et al.: Nationwide surveillance of bacterial respiratory pathogens conducted by the Japanese Society of Chemotherapy in 2007: general view of the pathogens antibacterial susceptibility. J. Infect. Chemother. 15: , ,919 Jpn. J. Antibiotics 62: , Jpn. J. Antibiotics 53: , Jpn. J. Antibiotics 57: , Jpn. J. Antibiotics 59: , Jpn. J. Antibiotics 63: , : 49 57, Clinical and Laboratory Standards Institute: Performance standards for antimicrobial susceptibility testing; Seventeenth Informational Supplement. M100-S17, UBUKATA, K.; T. MURAKI, A. IGARASHI, et al.: Identi cation of penicillin and other beta-lactam

13 Feb THE JAPANESE JOURNAL OF ANTIBIOTICS resistance in Streptococcus pneumoniae by polymerase chain reaction. J. Infect. Chemother. 3: , Jpn. J. Antibiotics 60: , Jpn. J. Antibiotics 61: , Streptococci Jpn. J. Antibiotics 62: , Jpn. J. Antibiotics 63: 1 10, Clinical and Laboratory Standards Institute: Performance standards for antimicrobial susceptibility testing; Nineteenth Informational Supplement. M100-S19, Streptococcus pneumoniae 51: 60 70, occult bacteremia 112: , CHIBA, N.; R. KOBAYASHI, K. HASEGAWA, et al.: Antibiotic susceptibility according to genotype of penicillin-binding protein and macrolide resistance genes, and serotype of Streptococcus pneumoniae isolates from community-acquired pneumonia in children. J. Antimicrob. Chemother. 56: , Streptococcus pneumoniae 80: 91 96, : 59 66, SAKAI, F.; N. CHIBA, A. ONO, et al.: Molecular epidemiologic characteristics of Streptococcus pneumoniae isolates from children with meningitis in Japan from 2007 through J. Infect. Chemother. doi: /s KYAW, M. H.; R. LYNFIELD, W. SCHAFFNER, et al.: Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae. N. Engl. J. Med. 354: , CDC: Emergence of antimicrobial-resistant serotype 19A Streptococcus pneumoniae Massachusetts, MMWR 56: , Streptococcus pneumoniae 78: , Streptococcus pneumoniae Jpn. J. Antibiotics 58: , : , PAN, X. S.; J. AMBLER, S. MEHTAR, et al.: Involvement of topoisomerase IV and DNA gyrase as cipro oxacin targets in Streptococcus pneumoniae. Antimicrob. Agents Chemother. 40: , RICHTER, S. S.; K. P. HEILMANN, S. E. BEEKMANN, et al.: The molecular epidemiology of Streptococcus pneumoniae with quinolone resistance mutations. Clin. Infect. Dis. 40: , BRUEGGEMANN, A. B.; S. L. COFFMAN, P. RHOMBERG, et al.: Fluoroquinolone resistance in Streptococcus pneumoniae in United States since Antimicrob. Agents Chemother. 46: , Streptococcus pneumoniae gyra parc 77: , DE CUETO, M.; J. M. RODRIGUEZ, M. J. SORIANO, et al.: Fatal levo oxacin failure in treatment of a bacteremic patient infected with Streptococcus pneumoniae with a preexisting parc mutation. J. Clin. Microbiol. 46: , 2008

14 14 14 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb Sensitivity surveillance of Streptococcus pneumoniae isolates for several antibacterial agents in Gifu and Aichi prefecture Research Laboratories, Toyama Chemical Co., Ltd., Working Group of Tokai Anti-biogram Study Group YURI FURUYA, YOSHIKO FUKUDA, NOBUHIKO NOMURA and JUNICHI MITSUYAMA Research Laboratories, Toyama Chemical Co., Ltd. YUKO ASANO Department of Clinical Laboratory Medicine, Ogaki Municipal Hospital HIROYUKI SUEMATSU Clinical Laboratories, Chuno Kosei Hospital YUUKI KAWAHARA Takayama Red Cross Hospital SHIGENORI MATSUBARA Matsubara Otorhinolaryngology Clinic TORU ARAI Tohno Kosei Hospital KUNITOMO WATANABE Division of Anaerobe Research, Life Science Research Center, Gifu University KAZUKIYO YAMAOKA Gifu University of Medical Science HARUKI SAWAMURA Gifu University School of Medicine MAYUMI TERAJI Hida Medical Laboratory YOKO MATSUKAWA Clinical Laboratories, Gifu Prefectual Tajimi Hospital TAKANORI MIYABE Clinical Laboratories, Tokai Central Clinical Laboratories, Tokai Central Hospital HIROSHIGE MIKAMO Department of Infection Control and Prevention, Aichi Medical University We investigated the susceptibility to antibacterials, genotype of penicillin-binding protein PBP genes and macrolide resistant genes, and the serotypes against 377 strains of Streptococcus pneumoniae isolated from medical facilities in Gifu and Aichi prefectures between June 2008 and April These results were compared with those against 160 strains of S. pneumoniae isolated in Referring to CLSI M100-S17, the overall incidence of penicillin-susceptible PSSP, penicillin-intermediate PISP and penicillin-resistant PRSP S. pneumoniae was %, % and 49 13% strains, respectively. PISP and PRSP were isolated higher in the material of nasal cavity and throat, and PRSP was isolated higher in the area of Chuno district. The number of gpssp with 3 normal PBP genes, gpisp with 1 or 2 normal PBP genes and gprsp with 3 abnormal genes was %, % and % strains, respectively. The isolates with no macrolide-resistant gene, only mefa, only ermb, and both mefa and ermb were %, %, % and 45 12%. The prevalent pneumococcal serotypes were type strains; 24%, following by type strains; 16% and type 6 56 strains; 15%. The 80% of pneumococcal serotypes of PRSP were serotype 19 and 6. The MIC 90 of each antibacterial was as follows; 0.1 g/ml for imipenem, panipenem and garenoxacin, 0.2 g/ml for moxi oxacin, 0.39 g/ml for meropenem and tosu oxacin, 0.78 g/ ml for amoxicillin, clavulanic acid/ amoxicillin, cefditoren and cefcapene, 1.56 g/ml for benzylpenicillin, piperacillin, cefteram and levo oxacin, 3.13 g/ml for cefotiam, omoxef and pazu oxacin, 6.25 g/ml for cefdinir, 12.5 g/ml for nor oxacin and minocycline, >100 g/ml for clarithromycin, and these MIC 90 s were about the same as those in 2004.

172( 38 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 2 Apr. 2002 1 19 6 2002 5 8 4 254 254 (PBP) 90 83 65 142 PBP pbp1a, pbp2x, pbp2b 121 (49%), pbp1a, pbp2x 30 (12%), pbp2x, pbp2b 16 (6%), pbp2x 61 (24%),

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