2013年に気道感染症小児から分離されたA群溶血性レンサ球菌の細菌学的検討―過去4回の調査成績と比較して―  [in Japanese] Bacteriological investigation of group A streptococcal isolates from children with respiratory tract infections in 2013: Comparison with four previous studies  [in Japanese]

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Abstract

2013年4月~2014年3月に,当院小児科を受診した気道感染症患者215例(6か月~14歳0か月,中央値5歳2か月)からA群溶血性レンサ球菌を215株分離した。全分離株についてT血清型と15種抗菌薬(PCG,AMPC,CTX,CTRX,CDTR,CFPN,PAPM,IPM,EM,CAM,CLDM,MINO,TFLX,LVFX,VCM)のMIC値を測定し,過去にわれわれが行った4回の調査成績と比較した。2013年の血清型別分離率は,12型34%,B3264型30%,1型11%,28型9%の順であった。各血清型の分離率は調査時期により異なったが,12型は過去4回を含むすべての調査において中心を占めていた。EM,CAM,CLDM,MINO,TFLX,LVFXにはそれぞれ58%,58%,49%,5%,8%,2%が耐性を示し,CLDM耐性株は全てEMおよびCAMにも耐性であった。過去4回を含む計1,696株において,βラクタム系抗菌薬およびVCMの耐性株はなかった。EMおよびCAM耐性率は,それぞれ1996年9%,未検討,2001年14%,13%,2003年20%,20%,2006年20%,20%と漸増し,2013年には共に58%まで上昇した。これまでに最も多く分離された12型では,血清型別のEMおよびCAM耐性率が2006年の共に20%から,2013年には共に85%と著しく上昇した。

From April 2013 to March 2014, we examined 215 group A streptococcal isolates from 215 patients with respiratory tract infections (age, 6 months to 14 years; median, 5 years and 2 months) confined in our Pediatrics Department. For all the isolates, we determined the T serotypes and MICs of 15 antimicrobial agents [benzylpenicillin (PCG), amoxicillin (AMPC), cefotaxime (CTX), ceftriaxone (CTRX), cefditoren (CDTR), cefcapene (CFPN), panipenem (PAPM), imipenem (IPM), erythromycin (EM), clarithromycin (CAM), clindamycin (CLDM), minocycline (MINO), tosufloxacin (TFLX), levofloxacin (LVFX), and vancomycin (VCM)]. We compared the results with those of our four previous studies (1996, n = 431; 2001, n = 317; 2003, n = 295; 2006, n = 438). In 2013, the most prevalent serotypes were T12 (34%), B3264 (30%), T1 (11%), and T28 (9%), in descending order. Although isolation rates varied, T12 was the most frequent in all previous studies (1996, 22%; 2001, 37%; 2003, 38%; 2006, 24%). Among all the isolates tested, 58%, 58%, 49%, 5%, 8%, and 2% showed resistance to EM, CAM, CLDM, MINO, TFLX, and LVFX, respectively. All the CLDM-resistant isolates were also resistant to EM and CAM. Among the 1,696 isolates in all 5 studies, no strain showed resistance to β-lactams or VCM. The EM and CAM resistance rates increased over time, being respectively 9% and untested in 1996, 14% and 13% in 2001, 20% and 20% in 2003, and 20% and 20% in 2006. In 2013, both rates increased to 58%. T12 serotype isolates showed marked increases in EM and CAM resistance rates from 20% in 2006 to 85% in 2013.

Journal

  • Japanese Journal of Medical Technology

    Japanese Journal of Medical Technology 65(2), 229-234, 2016

    Japanese Association of Medical Technologists

Codes

  • NII Article ID (NAID)
    130005151816
  • Text Lang
    JPN
  • ISSN
    0915-8669
  • Data Source
    J-STAGE 
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