242 ( 36 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 prulifloxacin * ** ** CMC * ** 2010 2 22 Prulifloxacin ulifloxacin (UFX) 3 1 2003 12 2004 5 19 534 2 2005 12 2006 5 19 805 3
THE JAPANESE JOURNAL OF ANTIBIOTICS 63 13 243 ( 37 ) 2007 12 2008 5 19 863 methicillin-susceptible Staphylococcus aureus (MSSA) Escherichia coli levofloxacin (MSSA, MIC 2 m g/ml; E. coli, MIC 4 m g/ml) 0% 11.8% 14.6 20.8% UFX UFX E. coli MIC 90 levofloxacin 1/2 1/4 Klebsiella pneumoniae UFX MIC 90 0.25 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) 2002 12 ulifloxacin (UFX) 1,2) 3,4) PUFX methicillin-resistant Staphylococcus aureus (MRSA) 2003 12 2008 5 3 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.) 1/10 0.1 mol NaOH 9/10 UFX OFLX LVFX CPFX GFLX 640 mg /ml TFLX 160 mg /ml
244 ( 38 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 Table 1. * ** 2. 2003 12 2004 5 6 1 2005 12 2006 5 6 2 2007 12 2008 5 6 3 Table 1 19 2,202 1 534 2 805 3 863 3. (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 18 18 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 42 42 Mc- Farland 0.5 Difco TM Mueller- Hinton broth (MHB Becton, Dickinson and Company) 10 8 CFU/mL MHB 100 10 6 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
THE JAPANESE JOURNAL OF ANTIBIOTICS 63 13 245 ( 39 ) UFX OFLX LVFX CPFX GFLX 0.008 mg/ml 64 mg/ml TFLX 0.008 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 2. 10 15 1 6 2 3 64 MSSE MIC 50%MIC (MIC 50 ) 90%MIC (MIC 90 ) Table 3 4 (1) (Table 3) MSSA UFX MIC 50 3 0.5 mg/ml MIC 90 1 1 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 90 3 32 mg/ml MIC (LVFX MIC: 8 mg/ml) 1 MSSE 2 UFX MIC 90 8 mg/ml MSSA 3 0.5 mg/ml MSSA UFX LVFX CPFX OFLX (2) (Table 4) E. coli UFX MIC 90 1 2 mg/ml 2 4 mg/ml 3 8 m g/ml P. mirabilis E. coli 3 MIC 90 1 8 K. pneumoniae UFX MIC 90 1 0.25 m g/ml 2 0.12 m g/ml 3 0.03 mg/ml P. aeruginosa 2
246 ( 40 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 *: methicillin-susceptible Table 2.
THE JAPANESE JOURNAL OF ANTIBIOTICS 63 13 247 ( 41 ) Table 3. * UFX, ulifloxacin; OFLX, ofloxacin; LVFX, levofloxacin; CPFX, ciprofloxacin; GFLX, gatifloxacin; TFLX, tosufloxacin. ** NA: not available
248 ( 42 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 Table 4. * UFX, ulifloxacin; OFLX, ofloxacin; LVFX, levofloxacin; CPFX, ciprofloxacin; GFLX, gatifloxacin; TFLX, tosufloxacin.
THE JAPANESE JOURNAL OF ANTIBIOTICS 63 13 249 ( 43 ) Table 4. * UFX, ulifloxacin; OFLX, ofloxacin; LVFX, levofloxacin; CPFX, ciprofloxacin; GFLX, gatifloxacin; TFLX, tosufloxacin.
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 90 0.12 m g/ml GFLX TFLX OFLX LVFX (Table 5) Shigella spp. UFX 5 0.03 mg/ml Peptostreptococcus spp. 21 UFX TFLX MIC 50 MIC 90 2 32 mg/ml (Table 6)
THE JAPANESE JOURNAL OF ANTIBIOTICS 63 13 251 ( 45 ) PUFX 1 3 5 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% 2002 5) 2004 6) 2007 7) MSSA LVFX 4.7% 5.5% 6.8% 3 LVFX 9 7 2 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)
252 ( 46 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 63 _ 3 1 37.5% 2 23.1% 3 22.7% 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 90 1 2 Salmonella spp. OFLX GFLX MORITA et al. 15) 17% GyrA 83 MIC 16,17) Peptostreptococcus spp. 21 GFLX 2 UFX UFX 2004 2006 PUFX (94.9%) (87.0%) 18)
THE JAPANESE JOURNAL OF ANTIBIOTICS 63 13 253 ( 47 ) 1) YOSHIDA, T. & S. MITSUHASHI : Antibacterial activity of NM394, the active form of prodrug NM441, a new quinolone. Antimicrob. Agents Chemother. 37: 793 800, 1993 2) NM441 in vitro in vivo 44(Sl): 26 41, 1996 3) prulifloxacin in vitro Jpn. J. Antibiotics 55: 778 790, 2002 4) Prulifloxacin NM394 Staphylococcus aureus, Escherichia coli Pseudomonas aeruginosa in vitro Jpn. J. Antibiotics 55: 791 799, 2002 5) 2002 52 11,475 Jpn. J. Antibiotics 58: 17 44, 2005 6) 2004 77 18,639 Jpn. J. Antibiotics 59: 428 451, 2006 7) 2007 72 13,571 Jpn. J. Antibiotics 62: 346 370, 2009 8) MURATANI, T. & T. MATSUMOTO: Bacterial resistance to antimicrobials in urinary isolates. Int. J. Antimicrob. Agents 24 (Suppl. 1): S28 31, 2004 9) 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, 2008 10) b- 54: 202 209, 2008 11) 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: 635 641, 2009 12) 21: 162 167, 2006 13) 22: 286 293, 2007 14) INOUE, M.; N. Y. LEE, S. W. HONG, et al.: PROTEKT 1999 2000: 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, 2004 15) MORITA, M.; K. HIROSE, N. TAKAI, et al. : Salmonella enterica serovar Typhi in Japan, 2001 2006: emergence of high-level fluoroquinolone-resistant strains. Epidemiol. Infect. 27: 1 4, 2009 16) 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: 4315 4323, 2007 17) 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. 40:1009 1013, 1996 18) Prulifloxacin 53: 317 329, 2008
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 2004. 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.