Molecular Epidemiology of Haemophilus influenzae Strains Isolated from Patients with Meningitis during 1999 to 2003:Isolated from Patients with Meningitis during 1999 to 2003
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概要
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A total of 535 <I>Haemophilus influenzae</I> strains from 226 Japanese institutions participating in the Nationwide Surveillance Study Group for Bacterial Meningitis were sent to our laboratory during 1999 to 2003. All strains were analyzed by PCR to identify the β-lactam resistance genes, and their susceptibilities to β-lactam agents were determined. These strains wereclassified into 6 genotype patterns and MIC<SUB>90</SUB> values for ampicillin (ABPC): (i) β-lactamase nonproducing, ABPC susceptible (BLNAS) strains and lacked all resistance genes (27.7% of isolates; MIC<SUB>90</SUB>, 0.5μg/ml); (ii) β-lactamase producing, ABPC resistant (BLPAR) strains (129%, 16μg/ml); (iii) β-lactamase nonproducing, ABPC resistant (Low-BLNAR) strains with a Asn 526 Lys amino acid substitution in <I>ftsI</I> gene encoding PBP3 (31.2%, 2μg/ml); (iv) β-lactamase nonproducing, ABPC resistant (BLNAR) strains with Ser 385 Thr and Asn 526 Lys substitutions in <I>ftsI</I> (172%, 8μg/ml); (v) amoxicillin/clavlanic acid resistant (BLPACR I) strains, having β-lactamase gene and a Asn 526 Lys amino acid substitution in <I>ftsI</I> (9.2%, 32μg/ml); and (vi) amoxicillin/clavlanic acid resistant (BLPACR II), having β-lactamase gene and <I>ftsI</I> substitutions as for BLNAR strains (19%, 64μg/ml). All but 4 strains were serotype b.<BR>The prevalence of BLNAR strains has increased exponentially: 0% (n=0/41) in 1999, 5.8% (n=4/69) in 2000, 14.1% (n=19/139) in 2001, 20.1% (n=32/159) in 2002 and 29.1% (n=37/127) in 2003. The MIC<SUB>90</SUB>s of BLNAR isolates except for ABPC were as follows: piperacillin, 0.125μg/ml; ceftriaxone, 0.25μg/ml; meropenem, 0.5μg/ml; cefotaxime, 1μg/ml; panipenem, 2μg/ml; cefozopran, 16μg/ml; and cefotiam, 64μg/ml.<BR>To prevent such resistance from the increasing, expedited vaccination, correctidentification of the BLNAR by molecularly, and the proper selection of proper antibiotics based on PK/PD must be taken.
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The Japanese Association for Infectious Diseases | 論文
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