Emergence of Haemophilus influenzae with low susceptibility to quinolones and persistence in tosufloxacin treatment

Tanaka, Emi; Hara, Naoki; Wajima, Takeaki; Ochiai, Shoko; Seyama, Shoji; Shirai, Atsuko; Shibata, Meiwa; Shiro, Hiroyuki; Natsume, Yoshiaki; Noguchi, Norihisa

doi:10.1016/j.jgar.2019.01.017

Cited by 22 publications

(16 citation statements)

References 17 publications

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“…It is of note that different reports have reanalyzed the use of quinolones in children, including neonates, and they have been considered to be safe and beneficial in specific circumstances, such as severe or lifethreating infections by quinolone-susceptible microorganisms; furthermore, secondary effects were considered reversible (88,(93)(94)(95)(96). In this line, several fluoroquinolones have been introduced in established pediatric antibacterial armamentariums, such as tosufloxacin in Japan for treating respiratory infections (97,98). Meanwhile, a recent meta-analysis and systematic review on the use of quinolones in pregnant women highlighted the safety of using fluoroquinolones during the first trimester of pregnancy (99).…”

Section: Figmentioning

confidence: 99%

Transferable Mechanisms of Quinolone Resistance from 1998 Onward

Ruiz

2019

Clin Microbiol Rev

115

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SUMMARY While the description of resistance to quinolones is almost as old as these antimicrobial agents themselves, transferable mechanisms of quinolone resistance (TMQR) remained absent from the scenario for more than 36 years, appearing first as sporadic events and afterward as epidemics. In 1998, the first TMQR was soundly described, that is, QnrA. The presence of QnrA was almost anecdotal for years, but in the middle of the first decade of the 21st century, there was an explosion of TMQR descriptions, which definitively changed the epidemiology of quinolone resistance. Currently, 3 different clinically relevant mechanisms of quinolone resistance are encoded within mobile elements: (i) target protection, which is mediated by 7 different families of Qnr (QnrA, QnrB, QnrC, QnrD, QnrE, QnrS, and QnrVC), which overall account for more than 100 recognized alleles; (ii) antibiotic efflux, which is mediated by 2 main transferable efflux pumps (QepA and OqxAB), which together account for more than 30 alleles, and a series of other efflux pumps (e.g., QacBIII), which at present have been sporadically described; and (iii) antibiotic modification, which is mediated by the enzymes AAC(6′)Ib-cr, from which different alleles have been claimed, as well as CrpP, a newly described phosphorylase.

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Section: Figmentioning

confidence: 99%

Transferable Mechanisms of Quinolone Resistance from 1998 Onward

Ruiz

2019

Clin Microbiol Rev

115

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“…Four strains showed a TFLX MIC of 1 mg/ml in this surveillance. Recently, some H. influenzae strains in pediatric patients have been found to have a low sensitivity to quinolones [15]. As such, these strains should be monitored carefully to avoid increasing in the future.…”

Section: Discussionmentioning

confidence: 99%

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

Ishiwada

Fujimaki

Matsumoto³

et al. 2021

Journal of Infection and Chemotherapy

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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

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“…In 2017, two isolates with TFLX MIC 1 µg/ml one from a child were identi ed. After the recent approval for treatment of respiratory infections in children as an additional indication in Japan, opportunities of prescribing TFLX are increasing, and there is a concern that this led to an increase in the prevalence of TFLX resistance 22 .…”

Section: Discussionmentioning

confidence: 99%

Monitoring Quinolone Resistance Due to Mutations in GyrA and ParC in <i>Haemophilus Influenzae</i>（2012-17）

Nagatomo

Shirakura

Fukuchi

et al. 2020

Showa Univ J Med Sci

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Knowing recent drug-resistant bacteria trends is important for proper antibacterial drug use to improve the prognosis of patients with infectious diseases and for public health. Because multiple quinolone antibacterial agents are simultaneously adopted in hospitals in Japan, we examined whether minimum inhibitory concentrations MICs against Haemophilus influenzae differ among quinolones. We determined MICs of six different quinolone antibacterial agents and performed molecular genetic analysis. We investigated-lactamase-producing and-lactamasenegative ampicillin-resistant BLNAR H. in uenzae using the nitroce n method in parallel. Overall, 144 clinical H. in uenzae strains isolated at the Showa University Hospital between 2012 and 2017 were subjected to MIC determination for penicillin/quinolone antibacterial agents using the Clinical and Laboratory Standards Institute broth microdilution method. Amino acid mutations in the quinolone resistance-determining regions were analyzed in the isolates showing an MIC value ≥ 0.25 µg/ml of quinolone antibacterial agents. BLNAR isolates increased from 2016 onward. Among quinolone antibacterial agents, all isolates remained susceptible to sita oxacin. However, for moxi oxacin MFLX , strains with an MIC value 0.5 µg/ml were detected every year since 2013 except in 2015. Amino acid mutations were investigated in 17 isolates 11.8 with MFLX MIC value ≥ 0.25 µg/ml and con rmed in 11 isolates 7.6 , of which 9 contained GyrA mutations. The results demonstrated that MFLX was useful for predicting the presence of amino acid mutations and 0.25 was an appropriate MIC threshold for this purpose. This screening procedure may be effective for reducing the inappropriate use of quinolones and controlling the emergence of drug-resistant H. in uenzae.

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Emergence of Haemophilus influenzae with low susceptibility to quinolones and persistence in tosufloxacin treatment

Cited by 22 publications

References 17 publications

Transferable Mechanisms of Quinolone Resistance from 1998 Onward

Transferable Mechanisms of Quinolone Resistance from 1998 Onward

Monitoring Quinolone Resistance Due to Mutations in GyrA and ParC in <i>Haemophilus Influenzae</i>（2012-17）

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