PROTEKT 1999–2000: a multicentre study of the antibiotic susceptibility of respiratory tract pathogens in Hong Kong, Japan and South Korea

Inoue, Matsuhisa; Lee, Nam Yong; Hong, Seto Wing; Lee, Kyung-Won; Felmingham, D.

doi:10.1016/j.ijantimicag.2003.07.002

Cited by 46 publications

(52 citation statements)

References 22 publications

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“…Among 188 clinical isolates, the prevalences of penicillin-intermediate and -resistant S. pneumoniae were 17.6% and 53.2%, respectively, findings similar to those of previous reports (9,10,25). Published cases of VTSP were all penicillin intermediate or penicillin resistant (2,6,8,13).…”

Section: Discussionsupporting

confidence: 90%

“…Over the past decade, the incidence of penicillin resistance in S. pneumoniae (PRSP) has increased dramatically, and vancomycin in combination with an extended-spectrum cephalosporin has become the treatment of choice for empirical therapy of patients with suspected or proven pneumococcal meningitis in areas where infections caused by PRSP have been documented (28). In Korea, the frequency of clinical isolates with resistance to penicillin has risen steadily, from 25% in 1990 to 71.5% in 2000 (9,11). Moreover, 34% of clinical isolates from 1989 to 1995 (24) and 47.7% of blood isolates from 1996 to 2000 were resistant to three or more classes of antibiotics (10).…”

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confidence: 99%

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Vancomycin-Tolerant Streptococcus pneumoniae in Korea

et al. 2006

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A nationwide surveillance study was undertaken to monitor antimicrobial resistance among clinical isolates of Streptococcus pneumoniae in Korea, with a special focus on vancomycin tolerance. For the 6-month period from March to August 2002, clinical isolates of S. pneumoniae were collected from 11 university hospitals and 1 reference laboratory. One-hundred eighty-eight isolates were measured for lysis rates after exposure to vancomycin for 4 h. Two vancomycin-tolerant S. pneumoniae (VTSP) strains, S3 and H8, were isolated from sputum cultures of two patients, who had stayed in intensive-care units of different hospitals with long-term antibiotic therapy and were not treated for pneumococcal pneumonia. The penicillin, cefotaxime, and vancomycin MICs for S3 were 8 g/ml, >16 g/ml, and 0.5 g/ml, and those for H8 were 2 g/ml, 2 g/ml, and 0.5 g/ml, respectively. While S3 belonged to serotype 23F and was autolysin defective, H8 belonged to serotype 13F and had intact autolysin. These strains were not clonally related as determined by pulsed-field gel electrophoresis of chromosomal DNA. In agreement with previous reports, both isolates showed pairing of TIGR4 vex2 with R6 pep27 and had two identical amino acid substitutions, Q441K in vncS and N25D in vex2. These findings indicate that two VTSP strains have emerged independently in Korea, suggesting a prevalence rate of 1.1%. The emergence of VTSP would be a serious threat in Korea, where there are significant rates of penicillin resistance in S. pneumoniae. Monitoring of the prevalence of VTSP and further investigation of the clinical relevance of VTSP are warranted.

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Section: Discussionsupporting

confidence: 90%

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confidence: 99%

Vancomycin-Tolerant Streptococcus pneumoniae in Korea

et al. 2006

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“…The recent increase in BLNAR strains has become a severe problem, leading to community-acquired infections (8,19). Fluoroquinolone-resistant H. influenzae isolates have occasionally been reported worldwide (1,4,13,15), but they have rarely been reported in Japan (9,10). Fluoroquinolones are effective against the causative agents of atypical pneumonia, such as Chlamydophila pneumoniae and Mycoplasma pneumoniae, as well as those of typical bacterial pneumonia, S. pneumoniae and H. influenzae.…”

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Emergence of Fluoroquinolone-Resistant Haemophilus influenzae Strains among Elderly Patients but Not among Children

et al. 2008

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We screened 457 Haemophilus influenzae strains isolated in Japan during 2002 to 2004 and identified 12 fluoroquinolone-resistant strains (2.6%). The resistant strains were divided into three genotypes (eight, three, and one of each type). These were isolated from patients over 58 years of age. Several fluoroquinolone-resistant clones appeared to have invaded the population of elderly patients in a particular area, Sapporo city.

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“…The MLSb phenotype is typically highly resistant to macrolides (i.e., an erythromycin MIC of Ͼ64 g/ml) and is prevalent in Europe and South Africa, whereas the M phenotype results in an intermediate level of resistance (an erythromycin MIC of 1 to 32 g/ml) and predominates in North America (19). The occurrence of macrolide-resistant S. pneumoniae is high in Asia (12,29) and reaches 68 to 78% in Japan (12,29). The rates of ermB-positive, mefA-positive, ermB-and mefA-positive (double positive), and ermB-and mefA-negative (double negative) strains in Japan were reported to be 36 to 41%, 27 to 37%, 1 to 3%, and 22 to 31%, respectively (12,24,34).…”

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Genotypes and Related Factors Reflecting Macrolide Resistance in Pneumococcal Pneumonia Infections in Japan

Isozumi¹,

Ito²,

Ishida

et al. 2007

J Clin Microbiol

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Although macrolide-resistant Streptococcus pneumoniae strains possessing either the ermB or mefA gene are very common in Japan, clinical and microbial factors in community-acquired pneumonia (CAP) caused by different macrolide resistance genotypes have not been evaluated. A multicenter study of CAP caused by S. pneumoniae was performed in Japan from 2003 to 2005. A total of 156 isolates were tested for susceptibility to antibiotics correlated with ermB and mefA genotyping. Independent relationships between tested variables and possession of either the ermB or the mefA gene were identified. Of 156 isolates, 127 (81.4%) were resistant to erythromycin, with the following distribution of resistance genotypes: ermB alone (50.0%), mefA alone (23.7%), and both ermB and mefA (7.1%). All isolates were susceptible to telithromycin. By multivariate analysis, oxygen saturation of <90% on admission increased the risk for ermBpositive pneumococcal pneumonia (odds ratio [OR] ‫؍‬ 11.1; 95% confidence interval [CI] ‫؍‬ 1.30 to 95.0; P ‫؍‬ 0.03), but there were no associations with mefA or with ermB mefA positivity. Penicillin nonsusceptibility was associated with mefA-positive and with ermB-and mefA-positive isolates (OR ‫؍‬ 14.2; 95% CI ‫؍‬ 4.27 to 46.9; P < 0.0001 and P < 0.0001, respectively) but not with ermB-positive isolates. The overall patient mortality was 5.1%. Mortality, the duration of hospitalization, and the resolution of several clinical markers were not associated with the different erythromycin resistance genotypes. In Japan, S. pneumoniae with erythromycin resistance or possession of ermB, mefA, or both genes was highly prevalent in patients with CAP. The risk factors for ermB-positive, mefA-positive, and double ermB-mefA-positive pneumococcal pneumonia were different, but the clinical outcomes did not differ.

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PROTEKT 1999–2000: a multicentre study of the antibiotic susceptibility of respiratory tract pathogens in Hong Kong, Japan and South Korea

Cited by 46 publications

References 22 publications

Vancomycin-Tolerant Streptococcus pneumoniae in Korea

Vancomycin-Tolerant Streptococcus pneumoniae in Korea

Emergence of Fluoroquinolone-Resistant Haemophilus influenzae Strains among Elderly Patients but Not among Children

Genotypes and Related Factors Reflecting Macrolide Resistance in Pneumococcal Pneumonia Infections in Japan

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