Antimicrobial susceptibility of respiratory tract pathogens in Japan during PROTEKT years 1-5 (1999-2004)
Matsuhisa Inoue1, David J Farrell, Kenichi Kaneko
1Kitasato University School of Medicine, Kanagawa, Japan. matsu@kitasato-u.ac.jp
Abstract:
Susceptibility to a range of antimicrobial agents was determined among isolates of Streptococcus pneumoniae, Streptococcus pyogenes, and Haemophilus influenzae collected in 12 centers throughout Japan during years 1-5 (the respiratory seasons of 1999-2004) of the longitudinal Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin study. The most frequent source of isolates of S. pneumoniae was from patients with community-acquired pneumonia (CAP) (25.3%). Reduced susceptibility to penicillin or erythromycin resistance was common among S. pneumoniae isolates (30.9-44.5% and 77.2-81.9%, respectively). The macrolide MIC(50) for S. pneumoniae was >or=128 microg/ml (azithromycin and erythromycin) and >or=64 microg/ml (clarithromycin). The erm(B) genotype accounted for the most erythromycin-resistant isolates in each study year. H. influenzae isolates were most commonly derived from patients with CAP (26.2%). The proportion of H. influenzae isolates that were beta-lactamase positive ranged between 4.3% and 9.7%. The prevalence of beta-lactamase-negative ampicillin-resistant isolates increased from 0.4% to 2.6% between years 1 and 4 then to 19.7% in year 5. S. pyogenes isolates were highly susceptible to most antimicrobial agents except macrolides and tetracycline. Telithromycin was highly active against all three pathogens examined throughout the study.
Insights
Antimicrobial resistance is a growing concern for Streptococcus pneumoniae, Streptococcus pyogenes, and Haemophilus influenzae in Japan. Telithromycin demonstrated high activity against these common respiratory pathogens.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Antimicrobial resistance poses a significant threat to public health, particularly for common respiratory pathogens.
- Longitudinal surveillance data are crucial for tracking resistance trends and informing treatment guidelines.
Purpose of the Study:
- To assess the antimicrobial susceptibility patterns of Streptococcus pneumoniae, Streptococcus pyogenes, and Haemophilus influenzae in Japan.
- To evaluate the in vitro activity of the ketolide telithromycin against these pathogens.
Main Methods:
- Prospective surveillance study conducted across 12 centers in Japan over 5 years (1999-2004).
- Isolates of S. pneumoniae, S. pyogenes, and H. influenzae were collected from patients, primarily those with community-acquired pneumonia (CAP).
- Antimicrobial susceptibility testing was performed, including determination of minimum inhibitory concentrations (MICs) and genotypic analysis (e.g., erm(B)).
Main Results:
- High rates of reduced susceptibility to penicillin (30.9-44.5%) and erythromycin (77.2-81.9%) were observed in S. pneumoniae isolates.
- Macrolide resistance in S. pneumoniae was frequently associated with the erm(B) genotype.
- H. influenzae showed increasing ampicillin resistance, with a significant rise in beta-lactamase-negative ampicillin-resistant strains by year 5 (19.7%).
- S. pyogenes isolates were generally susceptible, except to macrolides and tetracycline.
- Telithromycin exhibited potent activity against all three bacterial species throughout the study period.
Conclusions:
- Significant antimicrobial resistance exists among key respiratory pathogens in Japan, necessitating ongoing surveillance.
- The emergence of ampicillin resistance in H. influenzae is a notable trend.
- Telithromycin demonstrated excellent in vitro efficacy, suggesting its potential as a therapeutic option against these resistant organisms.
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