Nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis from male urethritis in Japan

Abstract

Genital chlamydial infection is a principal sexually transmitted infection worldwide. Chlamydia trachomatis can cause male urethritis, acute epididymitis, cervicitis, and pelvic inflammatory disease as sexually transmitted infections. Fortunately, homotypic resistant C. trachomatis strains have not been isolated to date; however, several studies have reported the isolation of heterotypic resistant strains from patients. In this surveillance study, clinical urethral discharge specimens were collected from patients with urethritis in 51 hospitals and clinics in 2009 and 38 in 2012. Based on serial cultures, the minimum inhibitory concentration (MIC) could be determined for 19 isolates in 2009 and 39 in 2012. In 2009 and 2012, the MICs (MIC90) of ciprofloxacin, levofloxacin, tosufloxacin, sitafloxacin, doxycycline, minocycline, erythromycin, clarithromycin, and azithromycin were 2 μg/ml and 1 μg/ml, 0.5 μg/ml and 0.5 μg/ml, 0.125 μg/ml and 0.125 μg/ml, 0.063 μg/ml and 0.063 μg/ml, 0.125 μg/ml and 0.125 μg/ml, 0.125 μg/ml and 0.125 μg/ml, 0.016 μg/ml and 0.016 μg/ml, and 0.063 μg/ml and 0.063 μg/ml, respectively. In summary, this surveillance project did not identify any resistant strain against fluoroquinolone, tetracycline, or macrolide agents in Japan.

Nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis from male urethritis in Japan: Comparison with the first surveillance report

“…Although C. trachomatis is the major pathogen in sexually transmitted infections, there have been surprisingly few reports on the susceptibility of C. trachomatis till date. Therefore, these first and second nationwide surveillance reports would be invaluable for clinicians and researchers who are engaged in studies on sexually transmitted infections (STIs) [1].…”

“…This surveillance study included male patients, with non-gonococcal urethritis or chlamydial urethritis, who were 16-years-old or older. Overall, the methods of this study were the same as those followed in the first study [1], except for the number of participating hospitals and clinics and project period. A total of 43 hospitals and clinics with a urology department participated in this study, from May 2016 to July 2017.…”

“…trachomatis, as the target microorganism, was identified using standard cell culture methods. The methods followed were the same as those in the first report [1], except for the time of inoculation and incubation. The day before inoculation, monolayers of HeLa229 cells were cultured (1.5-2.0 × 10 5 /well) in a 24-well cell culture plate, and the clinical specimen was added to the well with stirring.…”

“…Interestingly, although the antimicrobial resistance of Neisseria gonorrhoeae, which causes gonococcal urethritis, has been recognized as an emergent critical situation, there have been few reports on the antimicrobial resistance of C. trachomatis. In Japan, the first nationwide surveillance of the antimicrobial susceptibility of C. trachomatis was reported in 2016, and no resistant strains were detected therein [1]. This is the second surveillance project being carried out, since we wanted to monitor the development of antimicrobial resistance with the changing times.…”

The JAID/JSC guidelines to Clinical Management of Infectious Disease 2017 concerning male urethritis and related disorders

“…Spread of antibiotics resistant C. trachomatis is not observed [94] (IV, B). However, as there are cases of treatment failure due to reinfection and insufficient oral medication, drug administration guidance is necessary.…”