In vitro susceptibilities to levofloxacin and various antibacterial agents of 12,866 clinical isolates obtained from 72 centers in 2010

Keizo Yamaguchi, Akira Ohno, Yoshikazu Ishii, Kazuhiro Tateda, Morihiro Iwata, Kouji Akizawa, Chikara Shimizu, Tasuku Hayashi, Mitsuo Kaku, Hiroyuki Kunishima, Miho Kitagawa, Makoto Miki, Chizuko Kawamura, Minoru Yasujima, Hiromi Tashiro, Hiroko Horiuchi, Yosei Katayama, Akira Suwabe, Makiko Kurota, Kenji KikuchiSatoru Kuroki, Katsu Hirayama, Toshiaki Takahashi, Takanori Gotou, Keita Morikane, Reiko Ota, Takuo Nakagawa, Kyoji Moriya, Mitsuru Murata, Akiko Yoneyama, Shigemi Kondou, Shigeki Misawa, Imao Sekine, Joji Shiotani, Tomohiro Nakayama, Michiko Yagoshi, Hajime Horiuchi, Yoko Tazawa, Harushige Kanno, Masanori Aihara, Kenichiro Yamazaki, Hideyuki Okamoto, Kosuke Haruki, Junko Yazawa, Eiko Nagano, Motoi Okada, Yasuko Fukuda, Hiromi Ikari, Shigefumi Maesaki, Giichi Hashikita, Midori Sumitomo, Eiji Miyajima, Takefumi Saito, Nobuyuki Taniguchi, Akira Hishinuma, Yoshitaka Yamamoto, Yuki Okamoto, Nobuo Yamane, Ryou Maruyama, Chieko Kawashima, Masami Murakami, Sachie Yomoda, Tetsuo Machida, Yukio Ozaki, Takashi Uchida, Hisashi Baba, Yasuyuki Sugiura, Konomi Kondo, Takako Yamada, Hideo Gonda, Ikuo Yamaguchi, Toshiyuki Akahori, Keiichi Uemura, Masato Maekawa, Hitoshi Yoshimura, Kaname Nakatani, Yoshiko Matsushima, Tsutomu Nobori, Yoshinori Fujimoto, Yuko Asano, Asami Morinaga, Shinichi Fujita, Yasuko Senda, Yukio Hida, Masanori Yamashita, Haruyoshi Yoshida, Satoshi Ichiyama, Hidetoshi Okabe, Masayo Shigeta, Kaoru Shimizu, Hiroya Masaki, Hitoshi Heijyou, Hideo Nakaya, Takayuki Takubo, Tadashi Kusakabe, Tomonori Higashiyama, Hiroko Yoshida, Hiroshi Morishita, Shuji Matsuo, Hisashi Kono, Saori Fukuda, Reiko Sano, Yosuke Yuzuki, Norio Ikeda, Masaya Idomuki, Go Yamamoto, Syohiro Kinoshita, Seiji Kawano, Masao Doi, Yaeko Watanabe, Satomi Shimizu, Mikio Oka, Yoshihiro Kobashi, Nobuchika Kusano, Hiromitsu Fujiwara, Hiromi Murota, Shota Morishita, Atsushi Nagai, Hidehiko Moriyama, Yuki Taniguchi, Kiyoshi Negayama, Koji Murao, Hitoshi Miyamoto, Tetsuro Sugiura, Tamae Morita, Hiromi Tou, Akira Matsunaga, Dongchon Kang, Makiko Kiyosuke, Koichi Mashiba, Katsunori Yanagihara, Junichi Matsuda, Shigeru Kohno, Yosuke Aoki, Zenzo Nagasawa, Koji Kusaba, Kazufumi Hiramatsu, Tetsunori Saikawa, Hiroaki Miyanohara, Yuji Saeki, Ichiro Takajo, Akihiko Okayama, Nobuhisa Yamane, Isamu Nakasone

Research output: Contribution to journalReview article

25 Citations (Scopus)

Abstract

Postmarketing surveillance of levofloxacin (LVFX) has been conducted continuously since 1992. The present survey was performed to investigate in vitro susceptibility of recent clinical isolates in Japan to 30 selected antibacterial agents, focusing on fluoroquinolones (FQs). The common respiratory pathogens Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae continue to show a high susceptibility to FQs. In contrast, widely-prevailing resistance to macrolides was markedly noted among S. pneumoniae and S. pyogenes. Regarding H. influenzae, the prevalence of β-lactamase-negative ampicillin-resistant isolates has been increasing year by year (25.8% in 2002, 40.0% in 2004, 50.1% in 2007, and 57.9% in 2010). Enterobacteriaceae showed high susceptibility to FQs, however, prevalence of LVFX-resistant Escherichia coli, including intermediate resistance, was 29.3%, showing an increase over time. Nevertheless, the increase in the prevalence of LVFX-resistant E. coli isolates has slowed since 2007 (8.2% in 2000, 11.8% in 2002, 18.8% in 2004, 26.2% in 2007, and 29.3% in 2010), suggesting the influence of LVFX 500 mg tablets since its approval in 2009. Another Enterobacteriaceae member, Klebsiella pneumoniae, showed low resistance to FQs, in contrast with E. coli. In methicillin-resistant Staphylococcus aureus (MRSA), the percentage of FQ-susceptible isolates was low, at 51.6% for susceptibility to sitafloxacin, and at only around 10% for susceptibility to other FQs. However, methicillin-susceptible S. aureus (MSSA) isolates were highly susceptible to FQs, with the percentage ranging from 88.5% to 99.1%. The prevalence of FQs-resistant isolates in methicillin-resistant coagulase-negative staphylococci was higher than that in methicillin-susceptible coagulase-negative staphylococci, although it was lower than the prevalence of FQ-resistance in MRSA. The prevalence of FQs-resistant Pseudomonas aeruginosa isolates derived from urinary tract infections (UTIs) was 15.4-21.3%, higher than the prevalence of 6.1-12.3% in P. aeruginosa isolates from respiratory tract infections (RTIs). While this trend was consistent with the results of previous surveillance, gradual decreases were noted in the prevalence of FQ-resistant P. aeruginosa isolates derived from UTIs. The prevalence of multidrug-resistant P. aeruginosa was 2.3% among isolates derived from UTIs and 0.3% among isolates from RTIs, a decrease from the results of 2007, Acinetobacter spp. showed high susceptibility to FQs. Imipenem-resistant Acinetobacter baumannii, which is currently an emerging issue, was detected at a prevalence of 2.4% (13 isolates). Neisseria gonorrhoeae showed a high resistance of 81.3-82.5%, to FQs. Ceftriaxone (CTRX) continued to show 100% susceptibility until 2007, but the present survey revealed the advent of resistance to CTRX in some clinical isolates. The result of the present survey indicated that although methicillin-resistant staphylococci, Enterococcus faecium, P. aeruginosa from UTIs, N. gonorrhoeae, and E. coli showed resistance of about 20% or more (19.5-89.2%) against the FQs which have been used clinically for over 17 years, the trends observed were similar to the results of previous surveillance. While FQ resistance has been prevailing in E. coli, E. coli still shows more than 70% susceptibility to FQs. The other bacterial species maintained high susceptibility rates of greater than 80%, against FQs.

Original languageEnglish
Pages (from-to)181-206
Number of pages26
JournalJapanese Journal of Antibiotics
Volume65
Issue number3
Publication statusPublished - Jun 1 2012

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ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Yamaguchi, K., Ohno, A., Ishii, Y., Tateda, K., Iwata, M., Akizawa, K., Shimizu, C., Hayashi, T., Kaku, M., Kunishima, H., Kitagawa, M., Miki, M., Kawamura, C., Yasujima, M., Tashiro, H., Horiuchi, H., Katayama, Y., Suwabe, A., Kurota, M., ... Nakasone, I. (2012). In vitro susceptibilities to levofloxacin and various antibacterial agents of 12,866 clinical isolates obtained from 72 centers in 2010. Japanese Journal of Antibiotics, 65(3), 181-206.