Vol.62 No.1 January 2014

Nationwide survey of the development of drug resistance in the pediatric field in 2012: Drug sensitivity of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in Japan

Yoshitake Sato^1,5), Yoshikiyo Toyonaga^2,5), Hideaki Hanaki³⁾ and Keisuke Sunakawa^4,5)

¹⁾Department of Pediatrics, Fuji Heavy Industries Health Insurance Society Ota Memorial Hospital, 455-1 Oshima-cho, Ota, Gunma, Japan
²⁾Department of Pediatrics, Saitama Sekishinkai Hospital
³⁾The Kitasato Institute, Kitasato University Research Center for Anti-infectious Drugs
⁴⁾The Kitasato Institute, Kitasato University Research Organization for Infection Control Sciences
⁵⁾The Drug-resistant Pathogen Surveillance Group in Pediatric Infectious Disease

Abstract

We investigated drug susceptibilities to various antimicrobial drugs of 370 isolates of Streptococcus pneumoniae, 411 of Haemophilus influenzae, and 111 of Moraxella catarrhalis, which were isolated from pediatric patients with respiratory tract infections (upper respiratory inflammation, bronchitis, and pneumonia), meningitis, or sepsis at 22 sites that participated in the Japanese nationwide Drug-Resistant Pathogen Surveillance Group in Pediatric Infectious Disease between January and June 2012. The frequency of resistant bacterium isolation and the patient's background factors were also examined.
For S. pneumoniae, the isolation frequency of penicillin-susceptible S. pneumoniae (PSSP), penicillin-intermediate-resistant S. pneumoniae (PISP), and penicillin-resistant S. pneumoniae (PRSP) was 50.5%, 39.2%, and 10.3%, respectively. The isolation frequency of PISP+PRSP was 49.5%. The following drugs displayed an MIC₉₀ of ≤1 μg/mL against PRSP: tebipenem (TBPM), faropenem (FRPM), cefditoren (CDTR), panipenem (PAPM), doripenem (DRPM), meropenem (MEPM), garenoxacin (GRNX), vancomycin (VCM), and tosufloxacin (TFLX).
For H. influenzae, the isolation frequency of β-lactamase-nonproducing ABPC-susceptible H. influenzae (BLNAS), β-lactamase-nonproducing ABPC-intermediate-resistant H. influenzae (BLNAI), β-lactamase-nonproducing ABPC-resistant H. influenzae (BLNAR), β-lactamase-producing ABPC-resistant H. influenzae (BLPAR), and β-lactamase-producing CVA/AMPC-resistant H. influenzae (BLPACR) was 28.0%, 16.8%, 46.7%, 4.4%, and 4.1%, respectively. The isolation frequency of BLNAI+BLNAR was 63.5%. The following drugs displayed an MIC₉₀ of ≤1 μg/mL against BLNAI+BLNAR and β-lactamase-producing bacteria: CDTR, cefteram (CFTM), TBPM, tazobactam/piperacillin (TAZ/PIPC), MEPM, ceftriaxone (CTRX), cefotaxime (CTX), GRNX, levofloxacin (LVFX), and TFLX.
For M. catarrhalis, favorable susceptibility to the following drugs was noted: combinations of β-lactamase inhibitors and synthetic penicillins, third-generation cephems, carbapenems, macrolides, and quinolones. One strain, however, showed a low sensitivity to macrolides and quinolones.
A significant difference in the isolation frequency of antimicrobial-resistant S. pneumoniae was found depending on the existence of previous antibacterial agent usage, and that of antimicrobial-resistant H. influenzae was found depending on the age category (younger than 3 years, 3 years or older) and the existence of siblings.

Key word

child, infectious disease, surveillance, drug-resistance

Received

August 12, 2013

Accepted

November 13, 2013

Jpn. J. Chemother. 62 (1): 118-128, 2014