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Cho HK. Consideration in treatment decisions for refractory Mycoplasma pneumoniae pneumonia. Clin Exp Pediatr 2021; 64:459-467. [PMID: 33561337 PMCID: PMC8426095 DOI: 10.3345/cep.2020.01305] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 01/09/2021] [Accepted: 01/19/2021] [Indexed: 11/27/2022] Open
Abstract
Mycoplasma pneumoniae (MP) is the most common cause of childhood bacterial pneumonia. Although macrolide is known to be effective as a first-line therapy, the proportion of macrolide resistance in MP pneumonia has strikingly increased during recent 2 decades in East Asia. This is challenging to physicians since they have to decide more often whether to use secondary treatment. Diagnostic methods to detect macrolide-resistance of MP are currently not available in Korean hospitals. Even in the diagnosis of MP infection, both serologic and molecular test have limitation: inability to differentiate current illness from carriage or asymptomatic infection. Combining these 2 diagnostic methods and excluding infection caused by other respiratory pathogens allow a more reliable diagnosis. This effort is even more demanding in recent years to keep children from unnecessary exposure to secondary antibiotics. Although several observational studies have reported that tetracycline and fluoroquinolone, which are considered in the treatment of refractory MP pneumonia, have efficacy of shortening the duration of fever and respiratory symptoms, those findings need to be proven by well-designed prospective studies. The use of tetracycline and fluoroquinolone in children is generally tolerable, as supported by many observational data. However, since concerns about side effects still remain, careful consideration about benefits and risks is needed to decide their use.
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Affiliation(s)
- Hye-Kyung Cho
- Department of Pediatrics, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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2
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Takeuchi N, Ohkusu M, Hoshino T, Yamamoto S, Segawa S, Murata S, Ishiwada N. Emergence of Haemophilus influenzae with low susceptibility to quinolones isolated from pediatric patients in Japan. J Infect Chemother 2021; 27:1020-1026. [PMID: 33658143 DOI: 10.1016/j.jiac.2021.02.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/21/2021] [Accepted: 02/17/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In 2010, oral fluoroquinolone tosufloxacin (TFX) granules were released as the first oral respiratory quinolone for children in Japan. METHODS To investigate the recent trend of H. influenzae strains with low susceptibility to quinolones in children, we analyzed the gene sequences of quinolone resistance-determining regions (QRDRs) of gyrA, gyrB, parC, and parE of 23 clinical isolates from 15 patients aged <15 years with an MIC of ≥0.5 μg/mL for TFX from 2010 to 2018. RESULTS Amino acid substitutions were observed in both GyrA and ParC in 13 strains (81%, 13/16), except two strains with a TFX MIC of 0.5 μg/mL with amino acid substitution in only GyrA and one strain with a TFX MIC of 1 μg/mL with no amino acid substitution. Four ST422 strains were observed in 2018, the detection age range was wide (0-7 years), and the residential city was varied. A total of 3/15 patients had a clear history of TFX treatment. CONCLUSIONS Even for the strain with an MIC of 0.5 μg/mL for TFX, it is highly possible that it harbors a mutation in gyrA, which is the first step toward quinolone resistance, and it may also harbor mutations in both gyrA and parC. Furthermore, several specific sequence type quinolone-resistant H. influenzae strains, particularly ST422, may be widespread among children in Japan. It is necessary to investigate changes in resistance both at the MIC and gene levels. The continuous monitoring of strains and the use of antimicrobial drugs in treatment should be carefully observed.
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Affiliation(s)
- Noriko Takeuchi
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.
| | - Misako Ohkusu
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Tadashi Hoshino
- Division of Infectious Diseases, Chiba Children's Hospital, Chiba, Japan
| | - Shota Yamamoto
- Division of Infectious Diseases, Chiba Children's Hospital, Chiba, Japan
| | - Shunsuke Segawa
- Division of Clinical Laboratory, Chiba University Hospital, Chiba, Japan
| | - Shota Murata
- Division of Clinical Laboratory, Chiba University Hospital, Chiba, Japan
| | - Naruhiko Ishiwada
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
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3
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Ishiwada N, Fujimaki K, Matsumoto T, Kiyota H, Tateda K, Sato J, Hanaki H, Takayanagi R, Yamaguchi Y, Hoshino T, Kuroki H, Iwata S, Tajima T, Horikoshi Y, Shiro H, Bamba M, Kawamura N, Ouchi K, Matsubara K, Okada T, Furuno K, Tsumura N. Nationwide surveillance of bacterial pathogens isolated from children conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2017: General overview of pathogenic antimicrobial susceptibility. J Infect Chemother 2020; 27:139-150. [PMID: 33277177 DOI: 10.1016/j.jiac.2020.11.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/14/2020] [Accepted: 11/13/2020] [Indexed: 11/17/2022]
Abstract
A nationwide surveillance of the antimicrobial susceptibility of pediatric patients to bacterial pathogens was conducted by Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in Japan in 2017. The isolates were collected from 18 medical facilities between March 2017 and May 2018 by the three societies. Antimicrobial susceptibility testing was conducted at the central laboratory (Infection Control Research Center, Kitasato University, Tokyo) according to the methods recommended by the Clinical Laboratory Standards Institute. Susceptibility testing was evaluated in 926 strains (331 Streptococcus pneumoniae, 360 Haemophilus influenzae, 216 Moraxella catarrhalis, 5 Streptococcus agalactiae, and 14 Escherichia coli). The ratio of penicillin-resistant S. pneumoniae was 0% based on CLSI M100-ED29 criteria. However, three meropenem or tosufloxacin resistant S. pneumoniae isolates were obtained. Among H. influenzae, 13.1% of them were found to be β-lactamase-producing ampicillin resistant strains, while 20.8% were β-lactamase non-producing ampicillin-resistant strains. No capsular type b strains were detected. In M. catarrhalis, 99.5% of the isolates were β-lactamase-producing strains. All S. agalactiae and E. coli strains were isolated from sterile body sites (blood or cerebrospinal fluid). The ratio of penicillin-resistant S. agalactiae was 0%, while that of extended spectrum β-lactamase-producing E. coli was 14.3%.
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Affiliation(s)
- Naruhiko Ishiwada
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.
| | - Kazuo Fujimaki
- The Surveillance Committee of JSC, JAID, and JSCM, Tokyo, Japan; Fujifilm Toyama Chemical Co., Ltd, Japan
| | | | - Hiroshi Kiyota
- The Surveillance Committee of JSC, JAID, and JSCM, Tokyo, Japan
| | - Kazuhiro Tateda
- The Surveillance Committee of JSC, JAID, and JSCM, Tokyo, Japan
| | - Junko Sato
- The Surveillance Committee of JSC, JAID, and JSCM, Tokyo, Japan
| | - Hideaki Hanaki
- Infection Control Research Center, The Omura Satoshi Memorial Institution, Kitasato University, Tokyo, Japan
| | - Reiko Takayanagi
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Tohoku Rosai Hospital, Miyagi, Japan
| | - Yoshio Yamaguchi
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Infection and Allergy, Tochigi Medical Center, Tochigi, Japan
| | - Tadashi Hoshino
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Division of Infections Diseases, Chiba Children's Hospital, Chiba, Japan
| | - Haruo Kuroki
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Sotobo Children's Clinic, Chiba, Japan
| | - Satoshi Iwata
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Infection Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Tajima
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Hakujikai Memorial Hospital, Tokyo, Japan
| | - Yuho Horikoshi
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Division of Infections Diseases, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Hiroyuki Shiro
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Masahiro Bamba
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Naohisa Kawamura
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Osaka Rosai Hospital, Osaka, Japan
| | - Kazunobu Ouchi
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Kawasaki Medical School Hospital, Okayama, Japan
| | - Keita Matsubara
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan
| | - Takafumi Okada
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Shikoku Medical Center for Children and Adults, Kagawa, Japan
| | - Kenji Furuno
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of General Pediatrics and Interdisciplinary Medicine, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Naoki Tsumura
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Kurume University Hospital, Fukuoka, Japan
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Takeuchi N, Ohkusu M, Hishiki H, Fujii K, Hotta M, Murata S, Ishiwada N. First report on multidrug-resistant non-encapsulated Streptococcus pneumoniae isolated from a patient with pneumonia. J Infect Chemother 2020; 26:749-751. [PMID: 32409019 DOI: 10.1016/j.jiac.2020.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/30/2020] [Accepted: 02/20/2020] [Indexed: 11/25/2022]
Abstract
The non-encapsulated Streptococcus pneumoniae (NESp) has emerged and increased in the clinical setting. The majority of NESp strains have been isolated from the nasopharynxes of healthy carriers and from respiratory specimens of patients with otitis media. NESp strains were shown to be more effective than encapsulated counterparts at forming biofilms. Therefore, NESp should become one of the leading causes of emerging refractory respiratory disease after the introduction of pneumococcal conjugate vaccines. We report the first case of multidrug-resistant - including fluoroquinolone-resistant - NESp isolated from the intrabronchial aspirate of a patient with pneumonia. Drug-resistant NESp infections can possibly emerge as a clinical problem and thus the continuous monitoring of NESp infections is of utmost importance.
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Affiliation(s)
- Noriko Takeuchi
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.
| | - Misako Ohkusu
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Haruka Hishiki
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Katsunori Fujii
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Megumi Hotta
- Department of Clinical Laboratory, Chiba University Hospital, Chiba University Hospital, Chiba, Chiba, Japan
| | - Shota Murata
- Department of Clinical Laboratory, Chiba University Hospital, Chiba University Hospital, Chiba, Chiba, Japan
| | - Naruhiko Ishiwada
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
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5
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Kakuta R, Nakano R, Yano H, Ozawa D, Ohta N, Matsuoka T, Motoyoshi N, Kawamoto S, Saiki Y, Katori Y, Kaku M. First Two Cases of Infected Aortic Aneurysm Caused by Non-Vaccine Streptococcus pneumoniae Serotype 23A. Ann Lab Med 2020; 40:270-273. [PMID: 31858770 PMCID: PMC6933064 DOI: 10.3343/alm.2020.40.3.270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/19/2019] [Accepted: 11/12/2019] [Indexed: 11/19/2022] Open
Affiliation(s)
- Risako Kakuta
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | - Ryuichi Nakano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Nara, Japan
| | - Hisakazu Yano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Nara, Japan
| | - Daiki Ozawa
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Nobuo Ohta
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Takayuki Matsuoka
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Naotaka Motoyoshi
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shunsuke Kawamoto
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Yoshikatsu Saiki
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Yukio Katori
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mitsuo Kaku
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Division of Infectious Diseases and Infection Control, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
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6
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Hara N, Wajima T, Tanaka E, Noguchi N, Shirai A, Shibata M, Shiro H. Two Cases in which Tosufloxacin was Administered for Respiratory Infections that may have been Caused by Haemophilus influenzae less Susceptible to Quinolone. ACTA ACUST UNITED AC 2020. [DOI: 10.5649/jjphcs.46.211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Naoki Hara
- Pharmaceutical Department, Yokohama Rosai Hospital
- Department of Microbiology, Tokyo University of Pharmacy and Life Sciences
| | - Takeaki Wajima
- Department of Microbiology, Tokyo University of Pharmacy and Life Sciences
| | - Emi Tanaka
- Department of Microbiology, Tokyo University of Pharmacy and Life Sciences
| | - Norihisa Noguchi
- Department of Microbiology, Tokyo University of Pharmacy and Life Sciences
| | - Atsuko Shirai
- Clinical Laboratory Department, Yokohama Rosai Hospital
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7
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β-Lactamase-non-producing ampicillin-resistant Haemophilus influenzae is acquiring multidrug resistance. J Infect Public Health 2020; 13:497-501. [DOI: 10.1016/j.jiph.2019.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 11/18/2019] [Accepted: 11/24/2019] [Indexed: 11/13/2022] Open
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8
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Thornton RB, Hakansson A, Hood DW, Nokso-Koivisto J, Preciado D, Riesbeck K, Richmond PC, Su YC, Swords WE, Brockman KL. Panel 7 - Pathogenesis of otitis media - a review of the literature between 2015 and 2019. Int J Pediatr Otorhinolaryngol 2020; 130 Suppl 1:109838. [PMID: 31879085 PMCID: PMC7062565 DOI: 10.1016/j.ijporl.2019.109838] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To perform a comprehensive review of the literature from July 2015 to June 2019 on the pathogenesis of otitis media. Bacteria, viruses and the role of the microbiome as well as the host response are discussed. Directions for future research are also suggested. DATA SOURCES PubMed database of the National Library of Medicine. REVIEW METHODS PubMed was searched for any papers pertaining to OM pathogenesis between July 2015 and June 2019. If in English, abstracts were assessed individually for their relevance and included in the report. Members of the panel drafted the report based on these searches and on new data presented at the 20th International Symposium on Recent Advances in Otitis Media. CONCLUSIONS The main themes that arose in OM pathogenesis were around the need for symptomatic viral infections to develop disease. Different populations potentially having different mechanisms of pathogenesis. Novel bacterial otopathogens are emerging and need to be monitored. Animal models need to continue to be developed and used to understand disease pathogenesis. IMPLICATIONS FOR PRACTICE The findings in the pathogenesis panel have several implications for both research and clinical practice. The most urgent areas appear to be to continue monitoring the emergence of novel otopathogens, and the need to develop prevention and preventative therapies that do not rely on antibiotics and protect against the development of the initial OM episode.
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Affiliation(s)
- R B Thornton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; School of Biomedical Sciences, Faculty Health and Medical Science, University of Western Australia, Perth, Western Australia, Australia
| | - A Hakansson
- Experimental Infection Medicine, Dept. of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - D W Hood
- MRC Harwell Institute, Mammalian Genetics Unit, Harwell Campus, Oxfordshire, OX11 0RD, UK
| | - J Nokso-Koivisto
- Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - D Preciado
- Sheikh Zayed Center for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, USA; Division of Pediatric Otolaryngology, Children's National Health System, Washington, DC, USA
| | - K Riesbeck
- Clinical Microbiology, Dept. of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - P C Richmond
- School of Medicine, Division of Paediatrics, Faculty Health and Medical Science, University of Western Australia, Perth, Western Australia, Australia; Perth Children's Hospital, Perth, Western Australia, Australia
| | - Y C Su
- Clinical Microbiology, Dept. of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - W E Swords
- Department of Microbiology and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - K L Brockman
- Department of Microbiology & Immunology, Medical College of Wisconsin, Milwaukee, WI, USA.
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Sun J, Hong H, Zhu N, Han L, Suo Q. Response surface methodology to optimize the preparation of tosufloxacin tosylate/hydroxypropyl-β-cyclodextrin inclusion complex by supercritical antisolvent process. J Mol Struct 2019. [DOI: 10.1016/j.molstruc.2019.126939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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10
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Spectroscopic Analysis and Dissolution Properties Study of Tosufloxacin Tosylate/Hydroxypropyl-β-Cyclodextrin Inclusion Complex Prepared by Solution-Enhanced Dispersion with Supercritical CO2. J Pharm Innov 2019. [DOI: 10.1007/s12247-019-09405-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Earlier generation quinolones can be useful in identifying Haemophilus influenzae strains with low susceptibility to quinolone isolated from paediatric patients. J Med Microbiol 2019; 68:1227-1232. [DOI: 10.1099/jmm.0.001027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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12
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Takeuchi N, Ohkusu M, Wada N, Kurosawa S, Miyabe A, Yamaguchi M, Nahm MH, Ishiwada N. Molecular typing, antibiotic susceptibility, and biofilm production in nonencapsulated Streptococcus pneumoniae isolated from children in Japan. J Infect Chemother 2019; 25:750-757. [PMID: 31235348 DOI: 10.1016/j.jiac.2019.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 02/04/2019] [Accepted: 02/10/2019] [Indexed: 10/26/2022]
Abstract
The prevalence of nonencapsulated Streptococcus pneumoniae (NESp) has increased with the introduction of pneumococcal conjugate vaccines in children; however, the bacteriological characteristics of NESp have not been sufficiently clarified. In this study, NESp strains isolated from the nasopharyngeal carriage of children from four nursery schools in Japan were analyzed for molecular type, antibiotic susceptibility, and biofilm productivity. A total of 152 putative S. pneumoniae strains were identified by optochin-susceptibility analysis, of which 21 were not serotypeable by slide agglutination, quellung reaction, or multiplex PCR. Among these 21 strains, three were lytA-negative and, therefore, not S. pneumoniae. The remaining 18 strains were positive for lytA, ply, pspK, and bile solubility and were confirmed as NESp. Therefore, the isolation rate of NESp in the S. pneumoniae strains in this study was 12.0% (18/149). Molecular-typing analyses classified five strains as two existing sequence types (STs; ST7502 and ST7786), and 13 strains formed four novel STs. Horizontal spread was suspected, because strains with the same ST were often isolated from the same nursery school. The NESp isolates were generally susceptible to most antimicrobials, with the exception of macrolides; however, all isolates possessed more than one abnormal penicillin-binding protein gene. Furthermore, NESp strains were more effective than encapsulated counterparts at forming biofilms, which showed obvious differences in morphology. These data indicated that NESp strains should be continuously monitored as emerging respiratory pathogens.
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Affiliation(s)
- Noriko Takeuchi
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.
| | - Misako Ohkusu
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | | | - Satoko Kurosawa
- Kurosawa Children's and Internal Medicine Clinic, Tokyo, Japan
| | - Akiko Miyabe
- Division of Laboratory Medicine and Clinical Genetics, Chiba University Hospital, Chiba, Japan
| | | | - Moon H Nahm
- Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Naruhiko Ishiwada
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
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13
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Tanaka E, Hara N, Wajima T, Ochiai S, Seyama S, Shirai A, Shibata M, Shiro H, Natsume Y, Noguchi N. Emergence of Haemophilus influenzae with low susceptibility to quinolones and persistence in tosufloxacin treatment. J Glob Antimicrob Resist 2019; 18:104-108. [PMID: 30753907 DOI: 10.1016/j.jgar.2019.01.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/08/2019] [Accepted: 01/11/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The use of non-β-lactam agents has increased in Japan due to the prevalence of β-lactam-resistant pathogens. This study aimed to clarify the recent trend of antimicrobial susceptibility and molecular epidemiological features in Haemophilus influenzae. METHODS Fifty-seven Haemophilus influenzae isolated from a Japanese teaching hospital in 2017 were characterised, and the data were compared with those of a previous study. The MICs were determined using the broth dilution method. Genetic backgrounds were compared by multilocus sequence typing. The bactericidal activity of tosufloxacin at, or near, the therapeutic Cmax was determined in vitro, with susceptible isolates and quinolone low-susceptible isolates by time-kill assay. RESULTS The results of the susceptibility tests showed that >90% of isolates were susceptible to cephalosporins and carbapenems, whereas ampicillin-susceptible and clarithromycin-susceptible isolates decreased. Regarding quinolones, low-susceptible isolates were noted in 2017, although all isolates were judged as susceptible. All low-susceptible isolates had an amino acid substitution in GyrA, and two isolates had an additional substitution in ParC. These isolates had different genetic backgrounds. Furthermore, the time-kill kinetic assay using the Cmax of tosufloxacin indicated that the low-susceptible isolates could persist for at least 8hours. CONCLUSIONS This study revealed that Haemophilus influenzae has demonstrated multidrug low-susceptibility in recent years. The low-susceptible isolates had genetic diversity, meaning that resistance occurred independently.
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Affiliation(s)
- Emi Tanaka
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Tokyo 192-0392, Japan
| | - Naoki Hara
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Tokyo 192-0392, Japan; Japan Organization of Occupational Health and Safety, Yokohama Rosai Hospital, 3211 Kozukue, Kohoku, Yokohama, Kanagawa 222-0036, Japan
| | - Takeaki Wajima
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Tokyo 192-0392, Japan.
| | - Shoko Ochiai
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Tokyo 192-0392, Japan
| | - Shoji Seyama
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Tokyo 192-0392, Japan
| | - Atsuko Shirai
- Japan Organization of Occupational Health and Safety, Yokohama Rosai Hospital, 3211 Kozukue, Kohoku, Yokohama, Kanagawa 222-0036, Japan
| | - Meiwa Shibata
- Japan Organization of Occupational Health and Safety, Yokohama Rosai Hospital, 3211 Kozukue, Kohoku, Yokohama, Kanagawa 222-0036, Japan
| | - Hiroyuki Shiro
- Japan Organization of Occupational Health and Safety, Yokohama Rosai Hospital, 3211 Kozukue, Kohoku, Yokohama, Kanagawa 222-0036, Japan
| | - Yoshiaki Natsume
- Japan Organization of Occupational Health and Safety, Yokohama Rosai Hospital, 3211 Kozukue, Kohoku, Yokohama, Kanagawa 222-0036, Japan
| | - Norihisa Noguchi
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Tokyo 192-0392, Japan
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14
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Ghafari O, Sharifi A, Ahmadi A, Nayeri Fasaei B. Antibacterial and anti-PmrA activity of plant essential oils against fluoroquinolone-resistantStreptococcus pneumoniaeclinical isolates. Lett Appl Microbiol 2018; 67:564-569. [DOI: 10.1111/lam.13050] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 05/02/2018] [Accepted: 07/03/2018] [Indexed: 11/30/2022]
Affiliation(s)
- O. Ghafari
- Molecular Biology Research Center; Systems Biology and Poisonings Institute; Baqiyatallah University of Medical Sciences; Tehran Iran
| | - A. Sharifi
- Department of Pathobiology, Faculty of Veterinary Science; Bu-Ali Sina University; Hamedan Iran
| | - A. Ahmadi
- Molecular Biology Research Center; Systems Biology and Poisonings Institute; Baqiyatallah University of Medical Sciences; Tehran Iran
| | - B. Nayeri Fasaei
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine; University of Tehran; Tehran Iran
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15
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Fuzi M, Szabo D, Csercsik R. Double-Serine Fluoroquinolone Resistance Mutations Advance Major International Clones and Lineages of Various Multi-Drug Resistant Bacteria. Front Microbiol 2017; 8:2261. [PMID: 29250038 PMCID: PMC5715326 DOI: 10.3389/fmicb.2017.02261] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/02/2017] [Indexed: 01/06/2023] Open
Abstract
The major international sequence types/lineages of methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae and ESBL-producing E. coli were demonstrated to have been advanced by favorable fitness balance associated with high-level resistance to fluoroquinolones. The paper shows that favorable fitness in the major STs/lineages of these pathogens was principally attained by the capacity of evolving mutations in the fluoroquinolone-binding serine residues of both the DNA gyrase and topoisomerase IV enzymes. The available information on fitness balance incurred by individual and various combinations of mutations in the enzymes is reviewed in multiple species. Moreover, strong circumstantial evidence is presented that major STs/lineages of other multi-drug resistant bacteria, primarily vancomycin-resistant Enterococcus faecium (VRE), emerged by a similar mechanism. The reason(s) why the major ST/lineage strains of various pathogens proved more adept at evolving favorable mutations than most isolates of the same species remains to be elucidated.
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Affiliation(s)
- Miklos Fuzi
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Dora Szabo
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Rita Csercsik
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
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