呼吸器感染症原因微生物の質的変化による薬剤耐性化

• 生方 公子

  北里大学北里生命科学研究所 & 大学院感染制御科学府 北里大学北里生命科学研究所感染制御・免疫学部門感染情報学研究室

書誌事項

タイトル別名

• Drug resistance caused by qualitative changes in respiratory pathogen components

抄録

Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogens, and Mycoplasma pneumoniae are causative pathogens widely detected in community-aquired respiratory tract infections (RTIs). In Japan, the rapidly increasing prevalence of isolates resistant to multiple antibiotics is becoming a serious clinical problem.Resistanceto β-lactam agents in S. pneumoniae and H. influenzae has occurred due to changes in penicillin-binding proteins (PBPs) encoded by pbp genes.Macrolide resistance in S. pneumoniae and S. pyogenes are mediated by 2 mechanisms-efflux pumping by the mefA gene and methylation of the ribosomal protein by ermB or ermA (ermTR) genes. Macrolide resistance in M. pneumoniae is also mediated by a mutation detected in domain V of the 23 S rRNA gene.<BR>In Japan, although the frequency of S. pneumoniae resistant to new quinolones is 1-2%, we confirmed that the mechanism of resistance occurred due to mutations on the gyrA gene encoding DNA gyrase and those on the parC and parE genes encoding topoisomerase IV.<BR>Resistance caused by qualitative changes in pathogen components is characterized as intermediate resistance not clearly distinguished by conventional susceptibility testing.The resistant level is also the approximate concentration aquired by oral antibiotics dosing of β-lactams, macrolides, and new quinolone agents.Microorganisms bearing mutations in genes encoding resistance-associated enzymes are easily selected by insufficient concentrations of oral antibioitics.<BR>Several actions prevent such resistance from increasing: rapid identification of causative pathogens, vaccination against these pathogens, proper selection and use of antibiotics based on PK/PD, and the establishment of postmarketing surveillance of antibiotics.

収録刊行物

• 日本化学療法学会雑誌

  日本化学療法学会雑誌 54 (2), 69-93, 2006

  公益社団法人 日本化学療法学会

キーワード

• drug resistance
• qualitative alteration
• Streptococcus pneumoniae
• Haemophilus influenzae
• Mycoplasma pneumoniae

詳細情報

• CRID: 1390282681267259136
• NII論文ID: 130004102757
• NII論文ID: 10017967617
• NII書誌ID: AN10472127
• DOI: 10.11250/chemotherapy1995.54.69
• ISSN: 18845886
• ISSN: 13407007
• Web Site: https://search.jamas.or.jp/link/ui/2006146868
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可