Epidemiology of Streptococcus pneumoniae isolates from patients with meningitis between 1993 and 2002

• Chiba Naoko

  Kitasato Institute for Life Sciences & Graduate School of Infection Control Sciences, Kitasato University

• Hasegawa Keiko

  Kitasato Institute for Life Sciences & Graduate School of Infection Control Sciences, Kitasato University

• Kobayashi Reiko

  Pharmaceutical Center, Meiji Seika Kaihsha

• Suzuki Etsuko

  Pharmaceutical Center, Meiji Seika Kaihsha

• Iwata Satoshi

  Department of Pediatrics, Tokyo National Medical Center

• Sunakawa Keisuke

  Kitasato Institute for Life Sciences & Graduate School of Infection Control Sciences, Kitasato University Kitasato University

• Ubukata Kimiko

  Kitasato Institute for Life Sciences & Graduate School of Infection Control Sciences, Kitasato University Kitasato University

• 化膿性髄膜炎・全国サーベイランス研究班

Bibliographic Information

Other Title

• 化膿性髄膜炎例から分離されたＳｔｒｅｐｔｏｃｏｃｃｕｓ　ｐｎｅｕｍｏｎｉａｅの疫学解析―１９９３年から２００２年の分離株について―
• 1993年から2002年の分離株について

Abstract

We studied 304 meningitis cases, including 18 cases pneumococcal meningitis confirmed by direct PCR for cerebrospinal fluid between 1993 and 2003. We analyzed isolates of 199 strains from children and isolates of 105 strains from adults to determine antibiotic susceptibility, genotype of penicillin-binding protein (PBP) genes, and the serotype distribution of isolates. Isolates in which abnormal PBP genes of pbp 1 a, pbp 2 x, and pbp 2 b were identified by PCR were classified based on PCR results and MIC⁹⁰ of penicillin G as follows:(i) PSSP with 3 normal PBP genes (23.1%, MIC⁹⁰: 0.031 pg/mL), (ii) PISP with an abnormal pbp 2 x (19.9%, MIC⁹⁰: 0.063μg/mL);(iii) PISP with an abnormal pbp 2 b (0.7 MIC⁹⁰: 0.125, μg/mL);(iv) PISP with abnormal pbp 2x and pbp 2 b (5.9%%, 0.25μg/mL);(v) PISP with abnormal pbp 1 a and pbp 2 x (10.5%, 0.25μg/mL); and (vi) PRSP with 3 abnormal PBP genes (39.9%, 2μg/mL). The incidence of PRSP, PISP having abnormal pbp 1 a and pbp 2 x, and PISP having an abnormal pbp 2x in the last 3 years was significantly higher rather than in preceding years. The incidence of PRSP was also significantly higher in children (45.3%) than in adults 27.1% Panipenem showed an excellent MIC⁹⁰ of 0.125μg/mL against PRSP, followed by biapenem (0.25μg/mL), meropenem and vancomycin (0.5μg/mL), cefotaxime (1μg-/mL), ceftriaxone (2μg/mL), ampicillin (4μg/mL), and cefotiam (8μg/mL). Significantly prevalent pneumococcal serotypes of isolates from children were 6 B (25.4%), 19 F (19.0%), 23 F (13.8%), 6 A (10.1%), and 14 (7.9%), in that order, compared to 23 F (16.5%), 22 (12.4%), 3 (11.3%), 6 B (10.3%), 19 F (9.3%), and 10=14 (6.2%%) in adults. Serotypes of isolates from both generations differed significantly (X²=56.9656, p=0.0000 (**)). PRSP was more prevalent in serotypes in strains from children. For isolates in the last 3 years, in children, sevenvalent pneumococcal conjugate vaccine covered isolates in 76.7% and eleven valent vaccine 81.7 but coverage was apparently low in adults at 43.8% and 56.3%. These findings suggest the need to introduce conjugate vaccine at the earliest opportunity and to continue nationwide monitoring of meningitis in Japan.

Journal

• Japanese Journal of Chemotherapy

  Japanese Journal of Chemotherapy 51 (9), 551-560, 2003

  Japanese Society of Chemotherapy

Keywords

• 肺炎球菌
• 化膿性髄膜炎
• 薬剤感受性
• 血清型
• サーベイランス

Details

• CRID: 1390282681260921728
• NII Article ID: 130004298192
• NII Article ID: 10011693785
• NII Book ID: AN10472127
• DOI: 10.11250/chemotherapy1995.51.551
• ISSN: 18845886
• ISSN: 13407007
• Web Site: https://search.jamas.or.jp/link/ui/2004084289
• Text Lang: ja
• Data Source:
  • JaLC
  • CiNii Articles
• Abstract License Flag: Disallowed