Feb. 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 1 1 2008 2009 2011 10 25 2008 6 2009 4 Streptococcus pneumoniae 377 penicillin-binding protein: PBP 2004 S. pneumoniae 160
2 2 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb. 2012 CLSI M100-S17benzylpenicillin PCG MIC 0.05 g/ml S. pneumoniae penicillin-susceptible S. pneumoniae: PSSP 0.1 0.78 g/ml S. pneumoniae penicillin-intermediate S. pneumoniae: PISP 1.56 g/ml S. pneumoniae penicillinresistant S. pneumoniae: PRSP PSSP 143 38% PISP 185 49% PRSP 49 13% PISP PRSP PRSP PBP gpssp 23 6.1% 1 gpisp 173 46% 3 gprsp 181 48% 28 7.4% mefa 138 37% ermb166 44% 45 12% PBP 338 90% 19 92 24% 23 60 16% 6 56 15% PRSP 19 6 80% 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 2,3 1999 4 2002 5 2004 6 2006 7 S. pneumoniae 2008 2009 S. pneumoniae 2004 I. 1. 2008 6 2009 4 S. pneumoniae 377 5%Mueller Hinton MHA
Feb. 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 3 3 5 2. - 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 4 7 2007 CLSI M100-S17 9 PCG MIC 0.05 g/ml S. pneumoniae penicillin-susceptible S. pneumoniae: PSSP 0.1 0.78 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 377 49 1850 50948 48 43 12 50 138 37% 95 25% 69 18% 49 13% 11 2.9% 15 4.0%
4 4 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb. 2012 2. PSSP PISP PRSP S. pneumoniae 377 PCG MIC 2004 Fig. 1 PSSP 143 38% PISP 185 49% PRSP 49 13% 2004 PSSP 30% 38% PRSP 19% 13% 1 PSSP PISP PRSP Table 1 PRSP 11 18% 4.1% PSSP 51% 2004 6 PSSP PRSP 2 PSSP PISP PRSP Table 2PRSP 32% Fig. 1. S. pneumoniae PCG MIC 2004 Table 1.PSSP PISP PRSP
Feb. 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 5 5 Table 2.PSSP PISP PRSP Table 3.PBP 9.0%, 8.5% 4.4% PRSP 2004 6 PRSP 4.2% 19% 3. PBP PBP Table 3 377 gpssp 23 6.1% gpisp gprsp 173 46% 181 48% 2004 6 gprsp 2004 6 gprsp 73% 52% 28% 46% 4. Table 4 377 mefa ermb 28 7.4% mefa 138 37% ermb 166 44% 45 12% 2004 6 377 PBP
6 6 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb. 2012 Table 4. 338 90% gprsp mefa ermb 40 11% 5. 377 19 92 24% 23 60 16% 6 56 15% 73 19% PSSP 143 19 22 15% 9 12 8.4% 6 10 7.0% 3, 4, 7, 8, 10, 11, 14, 15, 18, 22, 23, 29, 31, 34 35 PISP 185 23 57 31% 19 54 29% 6 23 12% 15 11 5.9% 7, 10, 11, 14, 21, 32, 33, 35 46PRSP 49 6 23 47% 19 16 33% 80% 4, 10, 16, 23, 40 41 6. S. pneumoniae 377 PSSP 143 PISP 185 PRSP 49 MIC 50 MIC 90 Table 5 8 377 MIC 90 AMPC CVA/AMPC 0.78 g/ml PCG PIPC 1.56 g/ml PRSP MIC 90 PSSP 32 64 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 90 12.5 g/ml 2004 6 MIC 50 MIC 90 2004 LVFX LVFX MIC: 12.5 g/ml 1
Feb. 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 7 7 Table 5. S. pneumoniae 377 MIC 50, MIC 90
8 8 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb. 2012 Table 6. PSSP 143 MIC 50, MIC 90
Feb. 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 9 9 Table 7. PISP 185 MIC 50, MIC 90
10 10 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb. 2012 Table 8. PRSP 49 MIC 50, MIC 90
Feb. 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 11 11 III. 4 7,11 14 S. pneumoniae 1999 4 7 2008 2009 S. pneumoniae 377 2004 S. pneumoniae 160 PISP PRSP 3 PCG 1999 2004 1999 63% 2004 70% 6 2008 2009 62% 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 1 4 8 16 MIC PCG PBP PCG PRSP 2004 6 35% 9.0% 4.2% 19% S. pneumoniae 19F, 6B 23F 18 21 19, 6 23 23 7 19F, 6B 23F 7 22 19A 23 2004 MIC 50 MIC 90 MIC range 2004
12 12 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb. 2012 1 - PSSP PISP PRSPPISP PRSP MIC 90 PSSP 16 32 PSSP PISP PRSP 2004 LVFX 1 0.27% 2006 1.7% 7 LVFX 1.2 1.6% 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 2 1 1 24,28,29 LVFX QRDR 1 6% 3 LVFX QRDR 30 31 2004 1 23: 1318 1326 2007 2 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: 156 167, 2009 3 2007 72 12,919 Jpn. J. Antibiotics 62: 346 370, 2009 4 Jpn. J. Antibiotics 53: 652 659, 2000 5 2002 Jpn. J. Antibiotics 57: 172 186, 2004 6 2004 Jpn. J. Antibiotics 59: 137 151, 2006 7 Jpn. J. Antibiotics 63: 224 241, 2010 8 2007 56: 49 57, 2008 9 Clinical and Laboratory Standards Institute: Performance standards for antimicrobial susceptibility testing; Seventeenth Informational Supplement. M100-S17, 2007 10 UBUKATA, K.; T. MURAKI, A. IGARASHI, et al.: Identi cation of penicillin and other beta-lactam
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14 14 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 1 Feb. 2012 Sensitivity surveillance of Streptococcus pneumoniae isolates for several antibacterial agents in Gifu and Aichi prefecture 2008 2009 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 2009. These results were compared with those against 160 strains of S. pneumoniae isolated in 2004. Referring to CLSI M100-S17, the overall incidence of penicillin-susceptible PSSP, penicillin-intermediate PISP and penicillin-resistant PRSP S. pneumoniae was 143 38%, 185 49% 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 23 6.1%, 173 46% and 181 48% strains, respectively. The isolates with no macrolide-resistant gene, only mefa, only ermb, and both mefa and ermb were 28 7.4%, 138 37%, 166 44% and 45 12%. The prevalent pneumococcal serotypes were type 19 92 strains; 24%, following by type 23 60 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.