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The third national Japanese antimicrobial susceptibility pattern surveillance program: Bacterial isolates from
Kanao Kobayashi1, Shingo Yamamoto2, Satoshi Takahashi3
1Urogenital Sub-Committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, Japan Organization of Occupational Health and Safety, Chugoku Rosai Hospital, Hiroshima, Japan.
Abstract:
The antimicrobial susceptibility patterns of bacterial pathogens isolated from patients with complicated urinary tract infections were analyzed using national surveillance data. The data consisted of 881 bacterial strains from eight clinically relevant species. The data were collected for the third national surveillance project from January 2015 to March 2016 by the Japanese Society of Chemotherapy, the Japanese Association for Infectious Disease, and the Japanese Society of Clinical Microbiology. Surveillance was undertaken with the cooperation of 41 medical institutions throughout Japan. Fluoroquinolone required a MIC90 of 2-64 mg/L to inhibit the 325 Escherichia coli strains tested and the proportion of levofloxacin resistant E. coli strains increased to 38.5% from 29.6% in 2011 and 28.6% in 2008. The proportion of levofloxacin resistant strains of Pseudomonas aeruginosa and Enterococcus faecalis decreased from previous reports and the proportion of multidrug-resistant P. aeruginosa and carbapenem-resistant Enterobacteriaceae remained low. Among methicillin-resistant Staphylococcus aureus (MRSA) strains, strains with reduced susceptibility to vancomycin (minimum inhibitory concentration, 2 μg/mL) increased to 14.7% from 5.5%. Bacterial strains that produced extended-spectrum β-lactamase included E. coli (79 of 325 strains, 24.3%), Klebsiella pneumoniae (9 of 177 strains, 7.7%), and Proteus mirabilis (6 of 55 strains, 10.9%). The proportion of extended-spectrum β-lactamase producing E. coli and K. pneumoniae strains increased from previous surveillance reports.
Insights
Antimicrobial resistance is increasing in common urinary tract infection pathogens like E. coli, with rising fluoroquinolone resistance. However, resistance in Pseudomonas aeruginosa and carbapenem-resistant Enterobacteriaceae remains low.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Antimicrobial Resistance Surveillance
Background:
- Complicated urinary tract infections (cUTIs) pose a significant challenge due to evolving antimicrobial resistance patterns.
- National surveillance data is crucial for monitoring trends in bacterial pathogen susceptibility.
Purpose of the Study:
- To analyze the antimicrobial susceptibility patterns of bacterial pathogens causing cUTIs in Japan.
- To identify trends in resistance to key antimicrobial agents, including fluoroquinolones and vancomycin.
Main Methods:
- Analysis of 881 bacterial strains from eight species collected between January 2015 and March 2016.
- Utilized national surveillance data from 41 medical institutions across Japan.
- Determined minimum inhibitory concentrations (MIC90) for various antimicrobial agents.
Main Results:
- Levofloxacin resistance in Escherichia coli increased to 38.5%, while resistance in Pseudomonas aeruginosa and Enterococcus faecalis decreased.
- Reduced susceptibility to vancomycin in methicillin-resistant Staphylococcus aureus (MRSA) increased significantly to 14.7%.
- Extended-spectrum β-lactamase (ESBL) production rose in E. coli (24.3%) and Klebsiella pneumoniae (7.7%).
Conclusions:
- Rising fluoroquinolone resistance in E. coli is a concern for cUTI treatment in Japan.
- Increased vancomycin non-susceptibility in MRSA warrants attention.
- The growing prevalence of ESBL-producing E. coli and K. pneumoniae highlights the need for ongoing surveillance and infection control measures.
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