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1. MICS-Asia II: Model intercomparison and evaluation of ozone and relevant species

Author

Han, Z., Sakurai, T., Ueda, H., Carmichael, G.R., Streets, D., Hayami, H., Wang, Z., Thongboonchoo, N., Engardt, M., Bennet, C., Fung, C., Park, S.U., Kajino, M., Sartelet, K., Matsuda, K., Amann, M., Han, Z., Sakurai, T., Ueda, H., Carmichael, G.R., Streets, D., Hayami, H., Wang, Z., Thongboonchoo, N., Engardt, M., Bennet, C., Fung, C., Park, S.U., Kajino, M., Sartelet, K., Matsuda, K., and Amann, M.

Abstract

Eight regional Eulerian chemical transport models (CTMs) are compared with each other and with an extensive set of observations including ground-level oncentrations from EANET, ozone soundings from JMA and vertical profiles from the TRACE-P experiment to evaluate the models abilities in simulating O3 and relevant species (SO2, NO, NO2, HNO3 and PAN) in the troposphere of East Asia and to look for similarities and differences among model performances. Statistical analysis is conducted to help estimate the consistency and discrepancy between model simulation and observation in terms of various species, seasons, locations, as well as altitude ranges. In general, all models show a good skill of simulating SO2 for both ground level and the lower troposphere, although two of the eight models systematically overpredict SO2 concentration. The model skills for O3 vary largely with region and season. For ground-level O3, model results are best correlated with observations in July 2001. Comparing with O3 soundings measured in the afternoon reveals the best consistency among models in March 2001 and the largest disparity in O3 magnitude in July 2001, although most models produce the best correlation in July as well. In terms of the statistics for the four flights of TRACE-P experiment, most models appear to be able to accurately capture the variability in the lower troposphere. The model performances for NOx are relatively poor, with lower correlation and with almost all models tending to underpredict NOx levels, due to larger uncertainties in either emission estimates or complex chemical mechanism represented. All models exhibit larger RMSE at altitudes <2 km than 2 -5.5 km, mainly due to a consistent tendency of these models towards underprediction of the magnitude of intense plumes that often originate from near surface. Relatively lower correlation at altitudes 2-5.5 km may be attributed to the models limitation in representing convection or potential chemical processes. Mo

Published
2008

2. MICS-Asia II: Model inter-comparison and evaluation of acid deposition

Author

Wang, Z., Xie, F., Sakurai, T., Han, Z., Carmichael, G.R., Streets, D., Engardt, M., Holloway, T., Hayami, H., Kajino, M., Thongboonchoo, N., Bennet, C., Park, S.U., Fung, C., Chang, A., Sartelet, K., Amann, M., Wang, Z., Xie, F., Sakurai, T., Han, Z., Carmichael, G.R., Streets, D., Engardt, M., Holloway, T., Hayami, H., Kajino, M., Thongboonchoo, N., Bennet, C., Park, S.U., Fung, C., Chang, A., Sartelet, K., and Amann, M.

Published
2008

3. MICS-Asia II: Model intercomparison and evaluation of particulate sulfate, nitrate and ammonium

Author

Hayami, H., Sakurai, T., Han, Z., Ueda, H., Carmichael, G.R., Streets, D., Holloway, T., Wang, Z., Thongboonchoo, N., Engardt, M., Bennet, C., Fung, C., Chang, A., Park, S.U., Kajino, M., Sartelet, K., Matsuda, K., Amann, M., Hayami, H., Sakurai, T., Han, Z., Ueda, H., Carmichael, G.R., Streets, D., Holloway, T., Wang, Z., Thongboonchoo, N., Engardt, M., Bennet, C., Fung, C., Chang, A., Park, S.U., Kajino, M., Sartelet, K., Matsuda, K., and Amann, M.

Abstract

Eight chemical transport models participate in a model intercomparison study for East Asia, MICS-Asia II. This paper analyzes calculated results for particulate matter of sulfate, nitrate and ammonium through comparisons with each other and with monthly measurements at EANET (the acid deposition monitoring network in East Asia) and daily measurements at Fukue, Japan. To the EANET measurements, model ensemble means better agree with model individual results for sulfate and total ammonium, although total nitrate is consistently and considerably underestimated. To measurements at Fukue, the models show better agreement than for the EANET measurements. This is likely because Fukue is centered in many of the model domains, whereas the EANET stations are mostly in Southeast Asia and Russia. Moreover, it would be important that Fukue is in Northeast Asia, where the emission inventory is more reliable than Southeast Asia. The model-model comparisons are made in view of the total amount in the atmosphere, vertical profile, coefficient of variation in surface concentrations, and transformation changes with distance. All the models show reasonable tendencies in vertical profiles and composition ratios. However, total amounts in the atmosphere are discrepant among the models. The consistency of the total amount in the atmosphere would influence source-receptor analysis. It seems that model results would be consistent, if the models take into account the primitive processes like emission, advection/diffusion, chemical transformation and dry/wet deposition, no matter the processes are modeled simply or comprehensively. Through the comparison study, we learned that it would be difficult to find any problems from one comparison (model-observation comparison with one data or many but at one station or in a short period). Modelers tend to examine model performances only from model-observation comparisons. However, taking budget in a certain or whole model domain would be important, b

Published
2008

4. MICS-Asia II: The model intercomparison study for Asia Phase II methodology and overview of findings

Author

Carmichael, G.R., Sakurai, T., Streets, D., Hozumi, Y., Ueda, H., Park, S.U., Fung, C., Han, Z., Kajino, M., Engardt, M., Bennet, C., Hayami, H., Sartelet, K., Holloway, T., Wang, Z., Kannari, A., Fu, J., Matsuda, K., Thongboonchoo, N., Amann, M., Carmichael, G.R., Sakurai, T., Streets, D., Hozumi, Y., Ueda, H., Park, S.U., Fung, C., Han, Z., Kajino, M., Engardt, M., Bennet, C., Hayami, H., Sartelet, K., Holloway, T., Wang, Z., Kannari, A., Fu, J., Matsuda, K., Thongboonchoo, N., and Amann, M.

Abstract

Results from the Model Intercomparison Study Asia Phase II (MICS-Asia II) are presented. Nine differet regional modeling groups simulated chemistry and transport of ozone (O3), secondary aerosol, acid deposition, and associated precursors, using common emissions and boundary conditions derived from a global model. Four-month-long periods, representing 2 years and three seasons (i.e., March, July, and December in 2001, and March in 2002), are analyzed. New observational data, obtained under the EANET (the Acid Deposition Monitoring Network in East Asia) monitoring program, were made available for this study, and these data provide a regional database to compare with model simulations. The analysis focused around seven subject areas: O3 and related precursors, aerosols, acid deposition, global inflow of pollutants and precursor to Asia, model sensitivities to aerosol parameterization, analysis of emission fields, and detailed analyses of individual models, each of which is presented in a companion paper in this issue of "Atmospheric Environment". This overview discusses the major findings of the study, as well as informaton on common emissions, meteorological conditions, and observations.

Published
2008

5. MICS-Asia II: Impact of global emissions on regional air quality in Asia

Author

Holloway, T., Sakurai, T., Han, Z., Ehlers, S., Spak, S.N., Horowitz, L.W., Carmichael, G.R., Streets, D., Hozumi, Y., Ueda, H., Park, S.U., Fung, C., Kajino, M., Thongboonchoo, N., Engardt, M., Bennet, C., Hayami, H., Sartelet, K., Wang, Z., Matsuda, K., Amann, M., Holloway, T., Sakurai, T., Han, Z., Ehlers, S., Spak, S.N., Horowitz, L.W., Carmichael, G.R., Streets, D., Hozumi, Y., Ueda, H., Park, S.U., Fung, C., Kajino, M., Thongboonchoo, N., Engardt, M., Bennet, C., Hayami, H., Sartelet, K., Wang, Z., Matsuda, K., and Amann, M.

Abstract

This study quantifies the seasonality and geographic variability of global pollutant inflow to Asia. Asia is often looked to as a major "source" of intercontinental air pollution transport with rising emissions and efficient pollutant export processes. However, the degree to which foreign emissions have been "imported" to Asia has not been thoroughly examined. The Model Inter-Comparison Study for Asia (MICS-Asia) is an international collaboration to study air pollution transport and chemistry in Asia. Using the global atmospheric chemistry Model of Ozone and Related Tracers (MOZART v. 2.4), and comparing results with a suite of regional models participating in MICS-Asia, we find that imported O3 contributes significantly throughout Asia. The choice of upper boundary condition is found to be particularly important for O3, even for surface concentrations. Both North America and Europe contribute to ground-level O3 concentrations throughout the region, though the seasonality of these two sources varies. North American contributions peak at over 10% of monthly mean O3 during winter months in East Asia, compared to Europe's spring- and autumn-maxima (5-8%). In comparison to observed data from the Acid Deposition Monitoring Network in East Asia (EANET), MOZART concentrations for O3 generally fall within the range of the MICS models, but MOZART is unable to capture the fine spatial variability of shorter-lived species as well as the regional models.

Published
2008

6. The MICS-Asia study: Model intercomparison of long-range transport and sulfur deposition in East Asia

Author

Carmichael, G.R., Calori, G., Hayami, H., Uno, I., Cho, S., Engardt, M., Kim, S., Ichikawa, Y., Ikeda, Y., Woo, J.-H., Ueda, H., Amann, M., Carmichael, G.R., Calori, G., Hayami, H., Uno, I., Cho, S., Engardt, M., Kim, S., Ichikawa, Y., Ikeda, Y., Woo, J.-H., Ueda, H., and Amann, M.

Abstract

An intercomparison study involving eight long-range transport models for sulfur deposition in East Asia has been initiated. The participating models included Eulerian and Lagrangian frameworks, with a wide variety of vertical resolutions and numerical approaches. Results from this study, in which models used common data sets for emissions, meteorology, and dry, wet and chemical conversion rates, are reported and discussed. Model results for sulfur dioxide and sulfate concentrations, wet deposition amounts, for the period January and May 1993, are compared with observed quantities at 18 surface sites in East Asia. At many sites the ensemble of models is found to have high skill in predicting observed quantities. At other sites all models show poor predictive capabilities. Sourcereceptor relationships estimated by the models are also compared. The models show a high degree of consistency in identifying the main sourcereceptor relationships, as well as in the relative contributions of wet/dry pathways for removal. But at some locations estimated deposition amounts can vary by a factor or 5. The influence of model structure and parameters on model performance is discussed. The main factors determining the deposition fields are the emissions and underlying meteorological fields. Model structure in terms of vertical resolution is found to be more important than the parameterizations used for chemical conversion and removal, as these processes are highly coupled and often work in compensating directions.

Published
2002

7. Fourth national Japanese antimicrobial susceptibility pattern surveillance program: Bacterial isolates from patients with complicated urinary tract infections.

Author

Kobayashi K, Takahashi S, Yasuda M, Miyazaki J, Wada K, Matsumoto M, Hayami H, Yamamoto S, Kiyota H, Sato J, Matsumoto T, Hasegawa N, Kobayashi I, Masumori N, Kimura T, Yamada H, Nakagawa T, Kaneko T, Matsumoto K, Fujimura T, Kamei J, Ishikawa K, Fujimoto K, Nakai Y, Shigemura K, Sadahira T, Hinata N, Kitano H, Yamashita M, Yasufuku T, Komeda H, Hiyama Y, Takahashi Y, Kanamaru S, Murakami M, Arakawa S, Yamada D, Mita K, Hamasuna R, Tanaka K, Matsukawa M, Takaoka E, Shigeta M, Takenaka T, Nishino M, Ishitoya S, Hayakawa S, Okumura K, and Ueda M

Subjects
Humans, Japan epidemiology, Drug Resistance, Bacterial, Bacteria drug effects, Bacteria isolation & purification, Pseudomonas aeruginosa drug effects, Pseudomonas aeruginosa isolation & purification, Escherichia coli drug effects, Escherichia coli isolation & purification, Male, Methicillin-Resistant Staphylococcus aureus drug effects, Methicillin-Resistant Staphylococcus aureus isolation & purification, Female, Enterococcus faecalis drug effects, Enterococcus faecalis isolation & purification, Fluoroquinolones pharmacology, Fluoroquinolones therapeutic use, Epidemiological Monitoring, East Asian People, Urinary Tract Infections microbiology, Urinary Tract Infections epidemiology, Urinary Tract Infections drug therapy, Microbial Sensitivity Tests, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Levofloxacin pharmacology, Levofloxacin therapeutic use
Abstract

Introduction: Antimicrobial susceptibility patterns of bacterial pathogens isolated from patients with complicated urinary tract infections were analyzed using the national surveillance data, comprising 793 bacterial strains from eight clinically relevant species., Materials and Methods: Data were collected for the fourth national surveillance project from July 2020 to December 2021 by the Japanese Society of Chemotherapy, the Japanese Association for Infectious Disease, and the Japanese Society of Clinical Microbiology. Surveillance was supervised with the cooperation of 43 medical institutions throughout Japan., Results: Fluoroquinolone required a minimum inhibitory concentration (MIC) of 2-64 mg/L to inhibit the 330 tested Escherichia coli strains. The proportion of levofloxacin-resistant E. coli strains increased from 28.6% in 2008 to 29.6% in 2011, 38.5% in 2015, and 44.5% in 2021. The proportion of levofloxacin-resistant strains of Pseudomonas aeruginosa also increased from previous survey results, showing a continuing downward trend. Conversely, the proportion of levofloxacin-resistant strains of Enterococcus faecalis decreased relative to previous reports. Neither multidrug-resistant P. aeruginosa nor carbapenem-resistant Enterobacteriaceae were detected. For methicillin-resistant Staphylococcus aureus (MRSA), the proportion of vancomycin-susceptible strains (MIC of 2 μg/mL) decreased from 14.7% to 7.7%., Discussion: Bacterial strains that produced extended-spectrum β-lactamase included E. coli (82/330 strains, 24.8%), Klebsiella pneumoniae (11/68 strains, 16.2%), and Proteus mirabilis (4/26 strains, 15.4%). As compared to previous surveillance reports, these strains showed an increase in proportion over the years., Competing Interests: Declaration of competing interest Satoshi Takahashi received speaker honoraria from Fujirebio Inc. and research funding from Shino-Test Corporation, Roche Diagnostic K. K., Fujirebio Inc., and Abbott Japan Co., Ltd. Koichiro Wada received speaker honoraria from Janssen Pharmaceutical K.K., and MSD K.K. Shingo Yamamoto received speaker honoraria from MSD K.K., Fuso Pharmaceutical Industries, Ltd., Daiichi Sankyo Co., Ltd. and scholarship donations from Takeda Pharmaceutical Co., Ltd., Nippon Shinyaku Co., Ltd., Ono Pharmaceutical Co., Ltd., Bayer Yakuhin, Ltd. and research funding from Takeda Pharmaceutical Co., Ltd. Tetsuya Matsumoto received speaker honoraria from MSD K.K., Pfizer Japan Inc., and Kyorin Pharmaceutical Co., Ltd., and research funding from Kewpie Corporation., Biofermin Pharmaceutical Co., Ltd. Kazumasa Matsumoto received research funding from Sysmex Corporation. Tohru Nakagawa received speaker honoraria from Astellas Pharma Inc., AstraZeneca K.K., Ono Pharmaceutical Co., Ltd., and Janssen Pharmaceutical K.K., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Published
2024
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8. Third nationwide surveillance of bacterial pathogens in patients with acute uncomplicated cystitis conducted by the Japanese surveillance committee during 2020 and 2021: Antimicrobial susceptibility of Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus.

Author

Wada K, Tsuboi I, Takahashi S, Yasuda M, Miyazaki J, Kobayashi K, Matsumoto M, Hayami H, Yamamoto S, Kiyota H, Sato J, Matsumoto T, Hasegawa N, Kobayashi I, Masumori N, Kimura T, Yamada H, Matsumoto K, Ishikawa K, Fujimoto K, Shigemura K, Sadahira T, Ito K, Yokoyama T, Izumitani M, Sumii T, Hosobe T, Hikosaka K, Kawahara M, Sato T, Ito S, Masue N, Sakurai T, Kokura K, Kadena H, Morikawa T, Minamidate Y, Yoh M, Hashimoto J, Maruyama T, Yoshioka M, Takashima K, Kawai S, Nishi S, Matsumoto T, Hirayama H, Okusa H, Uno S, Inoue Y, Kurimura Y, Shirane T, Takaoka E, Tojo T, Arakawa S, Hamasuna R, Tomioka A, Iihara K, Ishitoya S, Maeda H, and Terado M

Subjects
Humans, Female, Klebsiella pneumoniae, Staphylococcus saprophyticus, Japan epidemiology, Bacteria, Fluoroquinolones, Escherichia coli, Cystitis drug therapy, Cystitis epidemiology, Cystitis microbiology
Abstract

The Japanese surveillance committee conducted a third nationwide surveillance of antimicrobial susceptibility of acute uncomplicated cystitis at 55 facilities throughout Japan between April 2020 and September 2021. In this surveillance, we investigated the susceptibility of Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Staphylococcus saprophyticus (S. saprophyticus) for various antimicrobial agents by isolating and culturing bacteria from urine samples. In total, 823 strains were isolated from 848 patients and 569 strains of target bacteria, including E. coli (n = 529, 92.9 %), K. pneumoniae (n = 28, 4.9 %), and S. saprophyticus (n = 12, 2.2 %) were isolated. The minimum inhibitory concentrations of 18 antibacterial agents were determined according to the Clinical and Laboratory Standards Institute manual. In premenopausal patients, there were 31 (10.5 %) and 20 (6.8 %) fluoroquinolone (FQ)-resistant E. coli and extended-spectrum β-lactamase (ESBL)-producing E. coli, respectively. On the other hand, in postmenopausal patients, there were 75 (32.1 %) and 36 (15.4 %) FQ-resistant E. coli and ESBL-producing E. coli, respectively. The rate of FQ-resistant E. coli and ESBL-producing E. coli in post-menopausal women was higher than that for our previous nationwide surveillance (20.7 % and 32.1 %: p = 0.0004, 10.0 % and 15.4 %; p = 0.0259). For pre-menopausal women, there was no significant difference in the rate of FQ-resistant E. coli and ESBL-producing E. coli between this and previous reports, but the frequency of FQ-resistant E. coli and ESBL-producing E. coli exhibited a gradual increase. For appropriate antimicrobial agent selection and usage, it is essential for clinicians to be aware of the high rate of these antimicrobial-resistant bacteria in acute uncomplicated cystitis in Japan., Competing Interests: Declaration of competing interest Koichiro Wada received speaker honoraria from Janssen Pharmaceuticals, Inc. Satoshi Takahashi received speaker honoraria from Fujirebio Inc. and research funding from Shino-Test Corporation, Roche Diagnostic K.K., Fujirebio Inc., and Abbott Japan Co., Ltd. Shingo Yamamoto received speaker honoraria from MSD K.K., Fuso Pharmaceutical Industries, Ltd., Daiichi Sankyo Co., Ltd. and scholarship donations from Takeda Pharmaceutical Co., Ltd., Nippon Shinyaku Co., Ltd., Ono Pharmaceutical Co., Ltd., Bayer Yakuhin, Ltd. and research funding from Takeda Pharmaceutical Co., Ltd. Tetsuya Matsumoto received speaker honoraria from MSD K.K., Pfizer Japan Inc., and Kyorin Pharmaceutical Co., Ltd., and research funding from Kewpie Corporation., Biofermin Pharmaceutical Co., Ltd. Kazumasa Matsumoto received research funding from Sysmex Corporation. Shin Ito received research funding from Hologic, Inc., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Published
2024
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9. The third nationwide surveillance of antimicrobial susceptibility against Neisseria gonorrhoeae from male urethritis in Japan, 2016-2017.

Author

Yasuda M, Takahashi S, Miyazaki J, Wada K, Kobayashi K, Matsumoto M, Hayami H, Yamamoto S, Kiyota H, Sato J, Matsumoto T, Yotsuyanagi H, Hanaki H, Masumori N, Hiyama Y, Nishiyama H, Kimura T, Yamada H, Matsumoto K, Ishikawa K, Togo Y, Tanaka K, Sadahira T, Inokuchi J, Hamasuna R, Ito K, Hirayama H, Hayashi K, Kurimura Y, Kadena H, Ito S, Shiono Y, Maruyama T, Ito M, Hatano K, Chokyu H, Ihara H, Uno S, Monden K, Yokoyama T, Kano M, Kaji S, Kawahara M, Sumii T, Tojo T, Hosobe T, Naito K, Kawai S, Nishimura H, Izumitani M, Yoh M, Matsumura M, Fujita R, Takayama K, Hara M, and Nishi S

Subjects
Humans, Male, Neisseria gonorrhoeae, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Cefixime pharmacology, Cefixime therapeutic use, Ceftriaxone therapeutic use, Azithromycin therapeutic use, Spectinomycin pharmacology, Spectinomycin therapeutic use, Japan epidemiology, Microbial Sensitivity Tests, Urethritis drug therapy, Urethritis epidemiology, Urethritis microbiology, Gonorrhea drug therapy, Gonorrhea epidemiology, Anti-Infective Agents therapeutic use
Abstract

Neisseria gonorrhoeae is one of the important pathogens of sexually transmitted infections. N. gonorrhoeae is rapidly becoming antimicrobial resistant, and there are few drugs that are effective in the initial treatment of gonorrhea. To understand the trends of antimicrobial susceptibility of N. gonorrhoeae, the Surveillance Committee of the Japanese Society of Infectious Diseases, the Japanese Society for Chemotherapy, and the Japanese Society of Clinical Microbiology conducted the third nationwide antimicrobial susceptibility surveillance of N. gonorrhoeae isolated from male urethritis. The specimens were collected from male patients with urethritis at 30 facilities from May 2016 to July 2017. From the 159 specimens collected, 87 N. gonorrhoeae strains were isolated, and 85 were tested for susceptibility to 21 antimicrobial agents. All strains were non-susceptible to penicillin G. Seven strains (8.2%) were β-lactamase-producing strains. The rates of susceptibility to cefixime and cefpodoxime were 96.5% and 52.9%, respectively. Three strains were non-susceptible with a minimum inhibitory concentration (MIC) of 0.5 mg/L for cefixime. None of the strains were resistant to ceftriaxone or spectinomycin. The susceptibility rate for ciprofloxacin was 23.5% (20 strains), and no strains showed intermediate susceptibility. The susceptibility rate against azithromycin was 81.2%, with one strain isolated with a MIC of 8 mg/L against azithromycin. The results of this surveillance indicate that ceftriaxone and spectinomycin, which are currently recommended for gonococcal infections in Japan, appear to be effective. It will be necessary to further expand the scale of the next surveillance to understand the current status of drug-resistant N. gonorrhoeae in Japan., Competing Interests: Declaration of competing interest Satoshi Takahashi received speaker honoraria from MSD K.K., Fujirebio Inc. and research funding from Shino-Test Corporation, Roche Diagnostic K.K., Fujirebio Inc., and Abbott Japan Co., Ltd. Shingo Yamamoto received speaker honoraria from MSD K.K., Fuso Pharmaceutical Industries, Ltd., Daiichi Sankyo Co., Ltd. and scholarship donations from Takeda Pharmaceutical Co., Ltd., Nippon Shinyaku Co., Ltd., Ono Pharmaceutical Co., Ltd., Bayer Yakuhin, Ltd. and research funding from Takeda Pharmaceutical Co., Ltd. Tetsuya Matsumoto received speaker honoraria from MSD K.K., Pfizer Japan Inc., and Kyorin Pharmaceutical Co., Ltd., and research funding from Kewpie Corporation., Biofermin Pharmaceutical Co., Ltd. Hiroyuki Nishiyama received research funding from Chugai Pharmaceutical Co., Ltd. Kazumasa Matsumoto received research funding from Sysmex Corporation. Junichi Inokuchi received research funding from Chugai Pharmaceutical Co., Ltd., (Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Published
2023
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10. Nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis from male urethritis in Japan: Comparison with the first surveillance report.

Author

Takahashi S, Yasuda M, Wada K, Matsumoto M, Hayami H, Kobayashi K, Miyazaki J, Kiyota H, Matsumoto T, Yotsuyanagi H, Tateda K, Sato J, Hanaki H, Masumori N, Hiyama Y, Egawa S, Yamada H, Matsumoto K, Ishikawa K, Yamamoto S, Togo Y, Tanaka K, Shigemura K, Uehara S, Kitano H, Kiyoshima K, Hamasuna R, Ito K, Hirayama H, Kawai S, Shiono Y, Maruyama T, Ito S, Yoh M, Ito M, Hatano K, Ihara H, Uno S, Monden K, Yokoyama T, Takayama K, Sumii T, Kadena H, Kawahara M, Hosobe T, Izumitani M, Kano M, Nishimura H, Fujita R, Kaji S, Hayashi K, Tojo T, and Matumura M

Subjects
Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Azithromycin pharmacology, Drug Resistance, Bacterial, Humans, Japan epidemiology, Male, Microbial Sensitivity Tests, Chlamydia trachomatis, Urethritis drug therapy, Urethritis epidemiology
Abstract

The Urogenital Sub-committee and the Surveillance Committee of the Japanese Society of Chemotherapy, The Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology conducted the second nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis. In this second surveillance study, clinical urethral discharge specimens were collected from patients with urethritis in 26 hospitals and clinics from May 2016 to July 2017. Based on serial cultures, the minimum inhibitory concentration (MIC) could be determined for 41 isolates; the MICs (MIC 90 ) of ciprofloxacin, levofloxacin, tosufloxacin, sitafloxacin, doxycycline, minocycline, erythromycin, clarithromycin, azithromycin and solithromycin were 2 μg/ml (2 μg/ml), 1 μg/ml (0.5 μg/ml), 0.25 μg/ml (0.25 μg/ml), 0.125 μg/ml (0.063 μg/ml), 0.125 μg/ml (0.125 μg/ml), 0.25 μg/ml (0.25 μg/ml), 0.031 μg/ml (0.031 μg/ml), 0.25 μg/ml (0.125 μg/ml), and 0.016 μg/ml (0.008 μg/ml), respectively. In summary, this surveillance project did not identify any strains resistant to fluoroquinolone, tetracycline, or macrolide agents in Japan. In addition, the MIC of solithromycin was favorable and lower than that of other antimicrobial agents. However, the MIC of azithromycin had a slightly higher value than that reported in the first surveillance report, though this might be within the acceptable margin of error. Therefore, the susceptibility of azithromycin, especially, should be monitored henceforth., (Copyright © 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2022
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11. The perspectives of people who use drugs regarding short term involuntary substance use care for severe substance use disorders.

Author

Chau LW, Erickson M, Vigo D, Lou H, Pakhomova T, Winston ML, MacPherson D, Thomson E, and Small W

Subjects
British Columbia, Humans, Drug Overdose, Drug Users, Pharmaceutical Preparations, Substance-Related Disorders therapy
Abstract

Background: In the Canadian Province of British Columbia (BC), the BC Mental Health Act permits involuntary care for treating mental disorders. However, the Act has also been applied to provide involuntary care to individuals with a primary substance use disorder, in the absence of specific guidelines and legislation, and with insufficient understanding of perspectives of people who use drugs (PWUD) regarding this approach., Methods: As part of a larger mixed-methods research project providing an overview of involuntary care for severe substance use disorders in BC, three focus groups were convened with: PWUD, families and caregivers, and Indigenous community stakeholders. This analysis examines perspectives from the focus group of PWUD, consisting of nine participants from local and regional drug user and advocacy organizations regarding involuntary care. A qualitative descriptive approach and thematic analysis were conducted, using a coding framework developed deductively and inductively, and participant perspectives were interpreted drawing on problematization theory., Results: Participants did not endorse the use of involuntary care, instead emphasizing significant changes were needed to address shortcomings of the wider voluntary care system. When asked to conceptualize what an acceptable involuntary care scenario might look like (under hypothetical and ideal conditions), participants recommended it should include: individual control and autonomy, peer advocacy in decision-making, and elimination of police and criminal justice system involvement from treatment encounters. Participants saw involuntary care to be an inappropriate approach given the shortcomings of the current system, noting also problems inherent in its use to manage severe SUDs and imminent harm, and prioritized alternate approaches to offsetting risks., Conclusion: Improving voluntary care for substance use, along with addressing the social determinants of health that put individuals at risk of problematic substance use and harm, were prioritized in participant perspectives. Participant comments regarding the use of involuntary care bring forward alternate solutions in the context of the opioid overdose crisis, and a reconceptualization of the 'problem' of managing severe substance use disorders., Competing Interests: Declarations of Interest None., (Copyright © 2021. Published by Elsevier B.V.)

Published
2021
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12. Nationwide surveillance of bacterial pathogens isolated from patients with acute uncomplicated cystitis in 2018: Conducted by the Japanese Research Group for Urinary Tract Infections (JRGU).

Author

Wada K, Yokoyama T, Uno S, Araki M, Sadahira T, Maruyama Y, Acosta H, Nakajima H, Hiyama Y, Kunishima Y, Togo Y, Nukaya T, Yamada H, Shigemura K, Ito S, Tanimura M, Kobayashi K, Kitano H, Teishima J, Yasuda M, Uehara S, Hamasuna R, Watanabe T, Nakagawa T, Hayami H, Miyazaki J, Takahashi S, Masumori N, Ishikawa K, Kiyota H, Fujisawa M, Arakawa S, Nasu Y, and Yamamoto S

Subjects
Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Bacteria, Escherichia coli, Female, Humans, Japan epidemiology, Microbial Sensitivity Tests, beta-Lactamases, Cystitis drug therapy, Cystitis epidemiology, Escherichia coli Infections drug therapy, Escherichia coli Infections epidemiology, Urinary Tract Infections drug therapy
Abstract

Introduction: The aim of this study was to monitor the development of drug-resistant bacteria isolated from acute uncomplicated cystitis (AUC) and to evaluate methodology of the survey conducted by collecting only clinical data., Methods: We enrolled female patients at least 16 years of age diagnosed with AUC in 2018. Patient information including age, menopausal status, and results of bacteriological examination were collected and analyzed regardless of bacterial identification, antimicrobial susceptibility testing or extended-spectrum β-lactamase (ESBL) detection method., Results: A total of 847 eligible cases were collected. Escherichia coli (E. coli) was the most frequently isolated bacterial species at about 70%, with proportions of fluoroquinolone-resistant E. coli (QREC) and ESBL-producing E. coli isolates at 15.6% and 9.5% of all E. coli isolates, respectively. The proportion of Staphylococcus saprophyticus (S. saprophyticus) was significantly higher in premenopausal women. Regarding the drug susceptibility of E. coli, isolates from Eastern Japan had significantly higher susceptibility to cefazolin, cefotiam and cefpodoxime and lower susceptibility to levofloxacin in postmenopausal women. ESBL-producing E. coli isolates had a high susceptibility to tazobactam-piperacillin, cefmetazole, carbapenems, aminoglycosides, and fosfomycin. In S. saprophyticus, the susceptibility to β-lactams including carbapenems was 40-60%., Conclusions: The proportions of QREC and ESBL-producing E. coli were increasing trends and lower susceptibility to LVFX in postmenopausal women was observed. Such surveillance, consisting of the collecting only clinical data, could be conducted easily and inexpensively. It is expected to be continuously performed as an alternative survey to conventional one collecting bacterial strains., (Copyright © 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2021
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13. The third national Japanese antimicrobial susceptibility pattern surveillance program: Bacterial isolates from complicated urinary tract infection patients.

Author

Kobayashi K, Yamamoto S, Takahashi S, Ishikawa K, Yasuda M, Wada K, Hamasuna R, Hayami H, Minamitani S, Matsumoto T, Kiyota H, Tateda K, Sato J, Hanaki H, Masumori N, Hiyama Y, Yamada H, Egawa S, Kimura T, Nishiyama H, Miyazaki J, Matsumoto K, Homma Y, Kamei J, Fujimoto K, Torimoto K, Tanaka K, Togo Y, Uehara S, Matsubara A, Shoji K, Goto H, Komeda H, Ito T, Mori K, Mita K, Kato M, Fujimoto Y, Masue T, Inatomi H, Takahashi Y, Ishihara S, Nishimura K, Mitsumori K, Ito N, Kanamaru S, Yamada D, Hiroshi M, Yamashita M, Tsugawa M, Takenaka T, Takahashi K, Oka Y, Yasufuku T, Watanabe S, Chihara Y, Okumura K, Kawanishi H, Matsukawa M, Shigeta M, and Koda S

Subjects
Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Bacteria drug effects, Bacterial Infections drug therapy, Bacterial Infections epidemiology, Drug Resistance, Bacterial drug effects, Enterococcus faecalis drug effects, Escherichia coli drug effects, Female, Fluoroquinolones therapeutic use, Humans, Japan epidemiology, Klebsiella pneumoniae drug effects, Levofloxacin pharmacology, Male, Methicillin-Resistant Staphylococcus aureus drug effects, Middle Aged, Proteus mirabilis drug effects, Pseudomonas aeruginosa drug effects, Urinary Tract Infections drug therapy, Vancomycin therapeutic use, Young Adult, Bacteria isolation & purification, Bacterial Infections microbiology, Microbial Sensitivity Tests methods, Urinary Tract Infections epidemiology, Urinary Tract Infections microbiology
Abstract

The antimicrobial susceptibility patterns of bacterial pathogens isolated from patients with complicated urinary tract infections were analyzed using national surveillance data. The data consisted of 881 bacterial strains from eight clinically relevant species. The data were collected for the third national surveillance project from January 2015 to March 2016 by the Japanese Society of Chemotherapy, the Japanese Association for Infectious Disease, and the Japanese Society of Clinical Microbiology. Surveillance was undertaken with the cooperation of 41 medical institutions throughout Japan. Fluoroquinolone required a MIC 90 of 2-64 mg/L to inhibit the 325 Escherichia coli strains tested and the proportion of levofloxacin resistant E. coli strains increased to 38.5% from 29.6% in 2011 and 28.6% in 2008. The proportion of levofloxacin resistant strains of Pseudomonas aeruginosa and Enterococcus faecalis decreased from previous reports and the proportion of multidrug-resistant P. aeruginosa and carbapenem-resistant Enterobacteriaceae remained low. Among methicillin-resistant Staphylococcus aureus (MRSA) strains, strains with reduced susceptibility to vancomycin (minimum inhibitory concentration, 2 μg/mL) increased to 14.7% from 5.5%. Bacterial strains that produced extended-spectrum β-lactamase included E. coli (79 of 325 strains, 24.3%), Klebsiella pneumoniae (9 of 177 strains, 7.7%), and Proteus mirabilis (6 of 55 strains, 10.9%). The proportion of extended-spectrum β-lactamase producing E. coli and K. pneumoniae strains increased from previous surveillance reports., Competing Interests: Declaration of Competing Interest Shingo Yamamoto has received speaker's honorarium from Daiichi Sankyo Co., Ltd., and scholarship donations from Astellas Pharma Inc., Takeda Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd, Pfizer Japan Inc., and Bayer Yakuhin, Ltd. Satoshi Takahashi has received speaker honoraria from Daiichi Sankyo Co., Ltd. and MSD K.K., and research grants from Shino-Test Corporation and Abbott Japan Co., Ltd. Ryoichi Hamasuna has received speaker's honorarium from Daiichi Sankyo Co. Ltd. Shinichiro Minamitani is an employee of Daiichi Sankyo Co., Ltd. Tetsuya Matsumoto has received speaker's honorarium from MSD K.K. and Pfizer Japan Inc. Hiroshi Kiyota and Hiroki Yamada have received scholarship donations from Taisho Toyama Pharmaceutical Co., Ltd., Toyama Chemical Co., Ltd., Daiichi Sankyo Co., Ltd., Astellas Pharma Inc., Taiho Pharmaceutical Co., Ltd., and Sanofi K.K. Kazuhiro Tateda received speaker honoraria from Pfizer Japan Inc., MSD K.K., Sumitomo Dainippon Pharma Co., Ltd., Taisho Toyama Pharmaceutical Co., Ltd. and Meiji Seika Pharma Co., Ltd., research funding from Meiji Seika Pharma Co., Ltd., Nippon Becton Dickinson Company, Ltd., Asahi Kasei Pharma Corporation, Eidia Co., Ltd., Eiken Chemical Co. Ltd., Nissui Pharmaceutical Co., Ltd., Spero OpCo, Inc., Shimadzu Corporation, Hitachi Ltd., Kyorin Pharmaceutical Co., Ltd., MSD K.K., Denka Company Limited, KD-ICONS Co. Ltd., and grant support from Taisho Toyama Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Asahi Kasei Pharma Corporation, Shionogi & Co., Ltd., Meiji Seika Pharma Co., Ltd., Daiichi Sankyo Co., Ltd., Pfizer Japan Inc., Astellas Pharma Inc., and FUJIFILM Toyama Chemical Co., Ltd., and scholarship donations from Taisho Toyama Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Asahi Kasei Pharma Corporation, Shionogi & Co., Ltd., Meiji Seika Pharma Co., Ltd., Daiichi Sankyo Co., Ltd., Pfizer Japan Inc., Astellas Pharma Inc. and FUJIFILM Toyama Chemical Co., Ltd., and has an endowed department sponsored by Meiji Seika Pharma Co., Ltd., Kyorin Pharmaceutical Co., Ltd., Astellas Pharma Inc., Taisho Toyama Pharmaceutical Co., Ltd., MSD K.K. and Daiichi Sankyo Co., Ltd. Hiroyuki Nishiyama has received speaker's honorarium from MSD K.K., AstraZeneca K.K., Chugai Pharmaceutical Co., Ltd. and Astellas Pharma Inc., research funding from Astellas Pharma Inc., Ono Pharmaceutical Co., Ltd. and Chugai Pharmaceutical Co., Ltd., and scholarship donations from Astellas Pharma Inc., Novartis Pharma K.K., Pfizer Japan Inc., Takeda Pharmaceutical Co., Ltd. and Ono Pharmaceutical Co., Ltd., (Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2020
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14. Second nationwide surveillance of bacterial pathogens in patients with acute uncomplicated cystitis conducted by Japanese Surveillance Committee from 2015 to 2016: antimicrobial susceptibility of Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus.

Author

Hayami H, Takahashi S, Ishikawa K, Yasuda M, Yamamoto S, Wada K, Kobayashi K, Hamasuna R, Minamitani S, Matsumoto T, Kiyota H, Tateda K, Sato J, Hanaki H, Masumori N, Nishiyama H, Miyazaki J, Fujimoto K, Tanaka K, Uehara S, Matsubara A, Ito K, Hayashi K, Kurimura Y, Ito S, Takeuchi T, Narita H, Izumitani M, Nishimura H, Kawahara M, Hara M, Hosobe T, Takashima K, Chokyu H, Matsumura M, Ihara H, Uno S, Monden K, Sumii T, Kawai S, Kariya S, Sato T, Yoshioka M, Kadena H, Matsushita S, Nishi S, Hosokawa Y, Shirane T, Yoh M, Watanabe S, Makinose S, Uemura T, and Goto H

Subjects
Adolescent, Adult, Anti-Bacterial Agents therapeutic use, Cystitis epidemiology, Cystitis microbiology, Epidemiological Monitoring, Escherichia coli isolation & purification, Escherichia coli metabolism, Female, Humans, Japan, Klebsiella pneumoniae isolation & purification, Klebsiella pneumoniae metabolism, Male, Microbial Sensitivity Tests, Middle Aged, Staphylococcus saprophyticus isolation & purification, Staphylococcus saprophyticus metabolism, Young Adult, beta-Lactamases metabolism, Anti-Bacterial Agents pharmacology, Cystitis drug therapy, Drug Resistance, Multiple, Bacterial, Escherichia coli drug effects, Klebsiella pneumoniae drug effects, Staphylococcus saprophyticus drug effects
Abstract

The Japanese Surveillance Committee conducted a second nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for acute uncomplicated cystitis (AUC) in premenopausal patients aged 16-40 years old at 31 hospitals throughout Japan from March 2015 to February 2016. In this study, the susceptibility of causative bacteria (Escherichia coli, Klebsiella pneumoniae, Staphylococcus saprophyticus) for various antimicrobial agents was investigated by isolation and culturing of organisms obtained from urine samples. In total, 324 strains were isolated from 361 patients, including E. coli (n = 220, 67.9%), S. saprophyticus (n = 36, 11.1%), and K. pneumoniae (n = 7, 2.2%). The minimum inhibitory concentrations (MICs) of 20 antibacterial agents for these strains were determined according to the Clinical and Laboratory Standards Institute (CLSI) manual. At least 93% of the E. coli isolates showed susceptibility to fluoroquinolones and cephalosporins, whereas 100% of the S. saprophyticus isolates showed susceptibility to fluoroquinolones and aminoglycosides. The proportions of fluoroquinolone-resistant and extended-spectrum β-lactamase (ESBL)-producing E. coli strains were 6.4% (13/220) and 4.1% (9/220), respectively. The antimicrobial susceptibility of K. pneumoniae was retained during the surveillance period, while no multidrug-resistant strains were identified. In summary, antimicrobial susceptibility results of our second nationwide surveillance did not differ significantly from those of the first surveillance. Especially the numbers of fluoroquinolone-resistant and ESBL-producing E. coli strains were not increased in premenopausal patients with AUC in Japan., (Copyright © 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2019
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16. Japanese guideline for clinical research of antimicrobial agents on urogenital infections: Second edition.

Author

Yasuda M, Muratani T, Ishikawa K, Kiyota H, Sakata H, Shigemura K, Takahashi S, Hamasuna R, Hayami H, Mikamo H, Yamamoto S, Watanabe T, and Arakawa S

Subjects
Age Factors, Anti-Infective Agents administration & dosage, Bacteria isolation & purification, Female, Humans, Japan, Male, Sex Factors, Treatment Outcome, Urinalysis instrumentation, Urinalysis methods, Urinary Tract Infections complications, Urinary Tract Infections microbiology, Urinary Tract Infections urine, Urine microbiology, Anti-Infective Agents therapeutic use, Bacteria drug effects, Clinical Trials as Topic standards, Urinary Tract Infections drug therapy
Published
2016
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17. Nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis from male urethritis in Japan.

Author

Takahashi S, Hamasuna R, Yasuda M, Ishikawa K, Hayami H, Uehara S, Yamamoto S, Minamitani S, Kadota J, Iwata S, Kaku M, Watanabe A, Sato J, Hanaki H, Masumori N, Kiyota H, Egawa S, Tanaka K, Arakawa S, Fujisawa M, Kumon H, Wada K, Kobayashi K, Matsubara A, Matsumoto T, Eto M, Tatsugami K, Kuroiwa K, Ito K, Hosobe T, Hirayama H, Narita H, Yamaguchi T, Ito S, Sumii T, Kawai S, Kanokogi M, Kawano H, Chokyu H, Uno S, Monden K, Kaji S, Kawahara M, Takayama K, Ito M, Yoshioka M, Kano M, Konishi T, Kadena H, Nishi S, Nishimura H, Yamauchi T, Maeda S, Horie M, Ihara H, Matsumura M, Shirane T, Takeyama K, Akiyama K, Takahashi K, Ikuyama T, Inatomi H, and Yoh M

Subjects
Adolescent, Adult, Cell Culture Techniques, Chlamydia Infections transmission, Chlamydia trachomatis isolation & purification, Humans, Japan epidemiology, Male, Microbial Sensitivity Tests, Middle Aged, Public Health Surveillance, Urethritis microbiology, Young Adult, Anti-Bacterial Agents pharmacology, Chlamydia Infections epidemiology, Chlamydia trachomatis drug effects, Drug Resistance, Bacterial, Fluoroquinolones pharmacology
Abstract

Genital chlamydial infection is a principal sexually transmitted infection worldwide. Chlamydia trachomatis can cause male urethritis, acute epididymitis, cervicitis, and pelvic inflammatory disease as sexually transmitted infections. Fortunately, homotypic resistant C. trachomatis strains have not been isolated to date; however, several studies have reported the isolation of heterotypic resistant strains from patients. In this surveillance study, clinical urethral discharge specimens were collected from patients with urethritis in 51 hospitals and clinics in 2009 and 38 in 2012. Based on serial cultures, the minimum inhibitory concentration (MIC) could be determined for 19 isolates in 2009 and 39 in 2012. In 2009 and 2012, the MICs (MIC90) of ciprofloxacin, levofloxacin, tosufloxacin, sitafloxacin, doxycycline, minocycline, erythromycin, clarithromycin, and azithromycin were 2 μg/ml and 1 μg/ml, 0.5 μg/ml and 0.5 μg/ml, 0.125 μg/ml and 0.125 μg/ml, 0.063 μg/ml and 0.063 μg/ml, 0.125 μg/ml and 0.125 μg/ml, 0.125 μg/ml and 0.125 μg/ml, 0.016 μg/ml and 0.016 μg/ml, and 0.063 μg/ml and 0.063 μg/ml, respectively. In summary, this surveillance project did not identify any resistant strain against fluoroquinolone, tetracycline, or macrolide agents in Japan., (Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2016
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18. Japanese nationwide surveillance in 2011 of antibacterial susceptibility patterns of clinical isolates from complicated urinary tract infection cases.

Author

Ishikawa K, Hamasuna R, Uehara S, Yasuda M, Yamamoto S, Hayami H, Takahashi S, Matsumoto T, Minamitani S, Kadota J, Iwata S, Kaku M, Watanabe A, Sunakawa K, Sato J, Hanaki H, Tsukamoto T, Kiyota H, Egawa S, Deguchi T, Matsumoto M, Tanaka K, Arakawa S, Fujisawa M, Kumon H, Kobayashi K, Matsubara A, Wakeda H, Amemoto Y, Onodera S, Goto H, Komeda H, Yamashita M, Takenaka T, Fujimoto Y, Tsugawa M, Takahashi Y, Maeda H, Onishi H, Ishitoya S, Nishimura K, Mitsumori K, Ito T, Togo Y, Nakamura I, Ito N, Kanamaru S, Hirose T, Muranaka T, Yamada D, Ishihara S, Oka H, Inatomi H, Matsui T, Kobuke M, Kunishima Y, Kimura T, Ichikawa T, Kagara I, Matsukawa M, Takahashi K, Mita K, Kato M, Okumura K, Kawanishi H, Hashimura T, Aoyama T, Shigeta M, Koda S, Taguchi K, and Matsuda Y

Subjects
Aged, Aged, 80 and over, Amikacin pharmacology, Ampicillin pharmacology, Ciprofloxacin pharmacology, Drug Resistance, Multiple, Bacterial, Escherichia coli drug effects, Female, Fluoroquinolones pharmacology, Humans, Imipenem pharmacology, Japan, Klebsiella oxytoca drug effects, Klebsiella pneumoniae drug effects, Linezolid pharmacology, Male, Microbial Sensitivity Tests, Middle Aged, Proteus mirabilis drug effects, Pseudomonas aeruginosa drug effects, Serratia marcescens drug effects, Vancomycin pharmacology, Anti-Bacterial Agents pharmacology, Enterococcus faecalis drug effects, Gram-Negative Bacteria drug effects, Methicillin-Resistant Staphylococcus aureus drug effects, Population Surveillance, Urinary Tract Infections microbiology
Abstract

To investigate antimicrobial susceptibility patterns of various bacterial pathogens isolated from complicated urinary tract infection (UTI) cases, the Japanese Society of Chemotherapy, the Japanese Association of Infectious Disease, and the Japanese Society of Clinical Microbiology conducted the second nationwide surveillance from January to September 2011. With the cooperation of 42 medical institutions throughout Japan, 1036 strains belonging to 8 clinically relevant bacterial species were collected. Among methicillin-resistant Staphylococcus aureus (MRSA) strain, the vancomycin (VCM) MIC for 5.5% (3/55) of the strains was 2 μg/mL. Ampicillin, VCM, and linezolid were relatively active against 209 Enterococcus faecalis strains. The proportion of fluoroquinolone (FQ)-resistant strains was >20%. The MIC90 of FQs against the 382 Escherichia coli strains was 2-64 mg/L and the proportion resistant to FQs was approximately 30%. However, susceptibility of E. coli to sitafloxacin was still high (MIC90 = 2 mg/L). Fifty-eight (15.2%) of 382 E. coli, 6 (4.5%) of 132 Klebsiella pneumoniae, 1 (2.4%) of 41 Klebsiella oxytoca and 4 (6.8%) of 59 Proteus mirabilis strains were suspected of producing extended-spectrum beta-lactamase. Of 93 Pseudomonas aeruginosa strains, the proportions resistant to imipenem, amikacin, and ciprofloxacin were 21.5%, 4.3%, and 20.4%, respectively. Four strains (4.3%) were found to be multidrug-resistant. In complicated UTI cases, all of MRSA and E. faecalis were susceptible to all anti-MRSA agents. Sitafloxacin was active against other FQ-resistant E. coli strains. The isolation of extended-spectrum beta-lactamase-producing and multidrug-resistant strains increased., (Copyright © 2015. Published by Elsevier Ltd.)

Published
2015
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19. The second nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan, 2012-2013.

Author

Hamasuna R, Yasuda M, Ishikawa K, Uehara S, Hayami H, Takahashi S, Matsumoto T, Yamamoto S, Minamitani S, Watanabe A, Iwata S, Kaku M, Kadota J, Sunakawa K, Sato J, Hanaki H, Tsukamoto T, Kiyota H, Egawa S, Tanaka K, Arakawa S, Fujisawa M, Kumon H, Kobayashi K, Matsubara A, Naito S, Kuroiwa K, Hirayama H, Narita H, Hosobe T, Ito S, Ito K, Kawai S, Ito M, Chokyu H, Matsumura M, Yoshioka M, Uno S, Monden K, Takayama K, Kaji S, Kawahara M, Sumii T, Kadena H, Yamaguchi T, Maeda S, Nishi S, Nishimura H, Shirane T, Yoh M, Akiyama K, Imai T, and Kano M

Subjects
Adolescent, Adult, Aged, Azithromycin pharmacology, Cefixime pharmacology, Ceftriaxone pharmacology, Fluoroquinolones pharmacology, Humans, Japan, Male, Microbial Sensitivity Tests, Middle Aged, Penicillins pharmacology, Young Adult, Anti-Bacterial Agents pharmacology, Drug Resistance, Bacterial, Neisseria gonorrhoeae drug effects, Population Surveillance, Urethritis microbiology
Abstract

Worldwide, the most important concern in the treatment of sexually transmitted infections is the increase in antimicrobial resistant Neisseria gonorrhoeae strains including resistance to cephalosporins, penicillins, fluoroquinolones or macrolides. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the second nationwide surveillance study. Urethral discharge was collected from male patients with urethritis at 26 medical facilities from March 2012 to January 2013. Of the 151 specimens, 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) 90% of ceftriaxone increased to 0.125 μg/ml, and 11 (10.7%) strains were considered less susceptible with an MIC of 0.125 μg/ml. There were 11 strains resistant to cefixime, and the MICs of these strains were 0.5 μg/ml. The distributions of the MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin, were bimodal. Sitafloxacin, a fluoroquinolone, showed strong activity against all strains, including strains resistant to other three fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin. The azithromycin MICs in 2 strains were 1 μg/ml., (Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2015
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20. Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) - a multi-center retrospective study.

Author

Togo Y, Kubo T, Taoka R, Hiyama Y, Uehara T, Hashimoto J, Kurimura Y, Takahashi S, Tsukamoto T, Miyazaki J, Nishiyama H, Kira S, Kiyota H, Yazawa S, Niwa N, Hongo H, Oya M, Kato T, Yasuda M, Deguchi T, Ishikawa K, Hoshinaga K, Matsumoto M, Shigemura K, Tanaka K, Arakawa S, Fujisawa M, Wada K, Uehara S, Watanabe T, Kumon H, Kobayashi K, Matsubara A, Matsumoto M, Sho T, Hamasuna R, Matsumoto T, Hayami H, Nakagawa M, and Yamamoto S

Subjects
Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Antibiotic Prophylaxis, Biopsy adverse effects, Biopsy methods, Escherichia coli isolation & purification, Escherichia coli Infections drug therapy, Escherichia coli Infections epidemiology, Escherichia coli Infections microbiology, Humans, Japan epidemiology, Male, Middle Aged, Postoperative Complications drug therapy, Retrospective Studies, Urinary Tract Infections drug therapy, Urinary Tract Infections microbiology, Biopsy statistics & numerical data, Postoperative Complications epidemiology, Prostate surgery, Urinary Tract Infections epidemiology
Abstract

We retrospectively investigated the incidence of genitourinary tract infection in 5895 patients who underwent transrectal and/or transperineal prostate biopsy procedure between January and December 2011 at 46 institutions belonging to Japanese Research Group for Urinary Tract Infection (JRGU). The total rate of genitourinary tract infection after prostate biopsy was 0.76%, while that following transrectal procedure was 0.83% and following transperineal procedure was 0.57%, which were not significantly different. In contrast, febrile infection associated with a fever (≥38 °C) occurred significantly more frequently after transrectal (0.71%) than transperineal (0.16%) approach (P = 0.04). Notably, in infectious cases, Escherichia coli was most frequently isolated. Of the 9 E. coli strains isolated by urine culture, 6 (66.7%) produced extended spectrum β-lactamase (ESBL) and 7 (77.8%) showed levofloxacin resistance. Similarly, of 6 E. coli strains isolated by blood culture, 4 (66.7%) produced ESBL and 6 (100%) showed levofloxacin resistance. When the efficacy of antimicrobial prophylaxis (AMP) with levofloxacin for the patients undergoing transrectal or transperineal biopsy was compared between a single dose (500 mg) and that given for 2 or more days, no significant difference was observed for the rate of infection (transrectal: 0.82% vs. 1.04%, p = 0.94; transperineal: 0.30% vs. 0.46%, p = 0.68). Although a single dose of levofloxacin for AMP is sufficient to prevent genitourinary infection after transrectal or transperineal prostate biopsy, and recommended in this era of increased multi-drug resistant pathogens, the increase in fluoroquinolone-resistant E. coli and ESBL-producing E. coli has emerged as a profound problem for surveillance., (Copyright © 2013 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2014
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21. Assessment of antimicrobial prophylaxis to prevent perioperative infection in patients undergoing prostate brachytherapy: multicenter cohort study.

Author

Taoka R, Togo Y, Kubo T, Kido M, Miki K, Kiyota H, Egawa S, Sugawara T, Yasuda M, Nakano M, Deguchi T, Nishino M, Ishikawa K, Shiroki R, Matsumoto M, Shigemura K, Tanaka K, Arakawa S, Fujisawa M, Wada K, Watanabe T, Kumon H, Kobayashi K, Matsubara A, Sho T, Hamasuna R, Matsumoto T, Hayami H, Nakagawa M, and Yamamoto S

Subjects
Aged, Aged, 80 and over, Bacterial Infections drug therapy, Humans, Incidence, Male, Middle Aged, Postoperative Complications drug therapy, Postoperative Complications prevention & control, Prostatic Neoplasms surgery, Retrospective Studies, Risk Factors, Treatment Outcome, Anti-Bacterial Agents therapeutic use, Antibiotic Prophylaxis, Bacterial Infections prevention & control, Brachytherapy adverse effects, Brachytherapy methods, Prostatic Neoplasms radiotherapy
Abstract

To propose an appropriate prophylactic antimicrobial therapy for patients undergoing brachytherapy, we evaluated the relationships between various antimicrobial prophylaxis (AMP) protocols and the incidence of postimplant infections in a multicenter cohort study conducted in Japan. The records of 826 patients with localized prostate cancer who underwent a transperineal (125)I brachytherapy procedure between January 2009 and December 2010 were retrospectively reviewed. Perioperative infections, including surgical site and remote infections, were recorded up to postoperative day 30. A total of 6 (0.73%) patients had a perioperative infection following seed implantation, of whom all received AMP for 1 or more days. None of the patients who received a single-dose protocol of AMP using fluoroquinolone p.o. or penicillin with a beta-lactamase inhibitor i.v. developed a perioperative infection. Statistical analysis showed that a single-dose protocol was more significantly related to a lower risk of perioperative infection as compared to the other AMP protocols examined (p = 0.045). Furthermore, our results indicated that bacteriuria and preoperative hair removal were risk factors of perioperative infection with statistical significance (p = 0.007, p = 0.004). Analysis of patient clinical parameters, including age, American Society of Anesthesiologists score, diabetes mellitus, prostate volume, numbers of implanted seeds and needle punctures, operation time, and indwelling duration time of the Foley catheter, did not reveal significant differences in terms of perioperative infection. Our results indicated that a single-dose AMP protocol is sufficient to prevent perioperative infections following seed implantation. On the other hand, AMP is only one of several measures to prevent perioperative infectious complications. It is necessary to know that the patient must have no bacteriuria and that preoperative hair removal should be avoided.

Published
2013
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22. Nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan.

Author

Hamasuna R, Yasuda M, Ishikawa K, Uehara S, Takahashi S, Hayami H, Yamamoto S, Matsumoto T, Minamitani S, Watanabe A, Iwamoto A, Totsuka K, Kadota J, Sunakawa K, Sato J, Hanaki H, Tsukamoto T, Kiyota H, Egawa S, Tanaka K, Arakawa S, Fujisawa M, Kumon H, Kobayashi K, Matsubara A, Naito S, Tatsugami K, Ito S, Narita H, Kanokogi M, Sumii T, Ito K, Hosobe T, Kawai S, Kawano H, Takayama K, Yamaguchi T, Endo K, Yamauchi T, Maeda S, Yoh M, Horie M, Ito M, Chokyu H, Ihara H, Akiyama K, Uno S, Monden K, Kaji S, Nishimura H, Kawahara M, Sato T, Konishi T, Nishi S, Ishihara S, and Yoshioka M

Subjects
Adolescent, Adult, Aged, Drug Resistance, Bacterial, Humans, Japan epidemiology, Male, Microbial Sensitivity Tests, Middle Aged, Neisseria gonorrhoeae isolation & purification, Prevalence, Public Health Surveillance, Anti-Bacterial Agents pharmacology, Neisseria gonorrhoeae drug effects, Urethritis epidemiology, Urethritis microbiology
Abstract

Neisseria gonorrhoeae is one of the most important pathogens causing sexually transmitted infection, and strains that are resistant to several antimicrobials are increasing. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the first nationwide surveillance. The urethral discharge was collected from male patients with urethritis at 51 medical facilities from April 2009 to October 2010. Of the 156 specimens, 83 N. gonorrhoeae strains were tested for susceptibility to 18 antimicrobial agents. The prevalence of β-lactamase-producing strains and chromosomally mediated resistant strains were 7.2 % and 16.5 %, respectively. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) of ceftriaxone for 7 strains (8.4 %) was 0.125 μg/ml. One strain was resistant to cefixime (MIC 0.5 μg/ml). The MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin, and tosufloxacin, showed a bimodal distribution. The MIC of sitafloxacin was lower than those of the three fluoroquinolones listed here, and it was found that the antimicrobial activity of sitafloxacin was stronger than that of the fluoroquinolones. The MIC of azithromycin in 2 strains was 2 μg/ml, but no high-level resistance to macrolides was detected.

Published
2013
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23. Nationwide surveillance of bacterial pathogens from patients with acute uncomplicated cystitis conducted by the Japanese surveillance committee during 2009 and 2010: antimicrobial susceptibility of Escherichia coli and Staphylococcus saprophyticus.

Author

Hayami H, Takahashi S, Ishikawa K, Yasuda M, Yamamoto S, Uehara S, Hamasuna R, Matsumoto T, Minamitani S, Watanabe A, Iwamoto A, Totsuka K, Kadota J, Sunakawa K, Sato J, Hanaki H, Tsukamoto T, Kiyota H, Egawa S, Tanaka K, Arakawa S, Fujisawa M, Kumon H, Kobayashi K, Matsubara A, Naito S, Tatsugami K, Yamaguchi T, Ito S, Kanokogi M, Narita H, Kawano H, Hosobe T, Takayama K, Sumii T, Fujii A, Sato T, Yamauchi T, Izumitani M, Chokyu H, Ihara H, Akiyama K, Yoshioka M, Uno S, Monden K, Kano M, Kaji S, Kawai S, Ito K, Inatomi H, Nishimura H, Ikuyama T, Nishi S, Takahashi K, Kawano Y, Ishihara S, Tsuneyoshi K, Matsushita S, Yamane T, Hirose T, Fujihiro S, Endo K, Oka Y, Takeyama K, Kimura T, and Uemura T

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Bacterial Infections epidemiology, Cystitis epidemiology, Escherichia coli isolation & purification, Female, Humans, Japan epidemiology, Male, Microbial Sensitivity Tests, Middle Aged, Public Health Surveillance, Staphylococcus saprophyticus isolation & purification, Anti-Bacterial Agents pharmacology, Bacterial Infections microbiology, Cystitis microbiology, Escherichia coli drug effects, Staphylococcus saprophyticus drug effects
Abstract

The Japanese surveillance committee conducted the first nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for female acute uncomplicated cystitis at 43 hospitals throughout Japan from April 2009 to November 2010. In this study, the causative bacteria (Escherichia coli and Staphylococcus saprophyticus) and their susceptibility to various antimicrobial agents were investigated by isolation and culturing of bacteria from urine samples. In total, 387 strains were isolated from 461 patients, including E. coli (n = 301, 77.8 %), S. saprophyticus (n = 20, 5.2 %), Klebsiella pneumoniae (n = 13, 3.4 %), and Enterococcus faecalis (n = 11, 2.8 %). S. saprophyticus was significantly more common in premenopausal women (P = 0.00095). The minimum inhibitory concentrations of 19 antibacterial agents used for these strains were determined according to the Clinical and Laboratory Standards Institute manual. At least 87 % of E. coli isolates showed susceptibility to fluoroquinolones and cephalosporins, and 100 % of S. saprophyticus isolates showed susceptibility to fluoroquinolones and aminoglycosides. The proportions of fluoroquinolone-resistant E. coli strains and extended-spectrum β-lactamase (ESBL)-producing E. coli strains were 13.3 % and 4.7 %, respectively. It is important to confirm the susceptibility of causative bacteria for optimal antimicrobial therapy, and empiric antimicrobial agents should be selected by considering patient characteristics and other factors. However, the number of isolates of fluoroquinolone-resistant or ESBL-producing strains in gram-negative bacilli may be increasing in patients with urinary tract infections (UTIs) in Japan. Therefore, these data present important information for the proper treatment of UTIs and will serve as a useful reference for future surveillance studies.

Published
2013
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24. A randomized clinical trial to evaluate the preventive effect of cranberry juice (UR65) for patients with recurrent urinary tract infection.

Author

Takahashi S, Hamasuna R, Yasuda M, Arakawa S, Tanaka K, Ishikawa K, Kiyota H, Hayami H, Yamamoto S, Kubo T, and Matsumoto T

Subjects
Adult, Aged, Female, Humans, Middle Aged, Phytotherapy, Young Adult, Beverages, Proanthocyanidins therapeutic use, Secondary Prevention, Urinary Tract Infections prevention & control, Vaccinium macrocarpon
Abstract

We examined the rate of relapse, as a variable index, in patients with urinary tract infection (UTI) who suffered from multiple relapses when using cranberry juice (UR65). A randomized, placebo-controlled, double-blind study was conducted from October 2007 to September 2009 in Japan. The subjects were outpatients aged 20 to 79 years who were randomly divided into two groups. One group received cranberry juice (group A) and the other a placebo beverage (group P). To keep the conditions blind, the color and taste of the beverages were adjusted. The subjects drank 1 bottle (125 mL) of cranberry juice or the placebo beverage once daily, before going to sleep, for 24 weeks. The primary endpoint was relapse of UTI. In the group of females aged 50 years or more, there was a significant difference in the rate of relapse of UTI between groups A and P (log-rank test; p = 0.0425). In this subgroup analysis, relapse of UTI was observed in 16 of 55 (29.1 %) patients in group A and 31 of 63 (49.2 %) in group P. In this study, cranberry juice prevented the recurrence of UTI in a limited female population with 24-week intake of the beverage.

Published
2013
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25. Sensitivities of major causative organisms isolated from patients with acute uncomplicated cystitis against various antibacterial agents: results of subanalysis based on the presence of menopause.

Author

Matsumoto T, Hamasuna R, Ishikawa K, Takahashi S, Yasuda M, Hayami H, Tanaka K, Muratani T, Monden K, Arakawa S, and Yamamoto S

Subjects
Acute Disease, Adult, Aged, Drug Resistance, Bacterial, Female, Humans, Microbial Sensitivity Tests, Middle Aged, Multivariate Analysis, Risk Factors, Anti-Bacterial Agents pharmacology, Bacteria drug effects, Bacterial Infections microbiology, Cystitis microbiology, Menopause
Abstract

We investigated whether the presence of menopause influenced the species and distribution of causative bacteria isolated from patients with acute uncomplicated cystitis (the most common urinary tract infection), and we also investigated the sensitivity of the isolated species to antibacterial agents. Using multivariate analysis, we also investigated risk factors for infection with quinolone-resistant Escherichia coli, because its frequency has increased and it is now a clinical problem in Japan. Six hundred and thirty-four strains were isolated from 489 premenopausal patients (mean age 32.3 ± 10.1 years). Major causative bacteria detected were Escherichia coli (65.0 %), Enterococcus faecalis (12.0 %), Streptococcus agalactiae (5.5 %), and Klebsiella pneumoniae (1.6 %). From 501 postmenopausal patients (mean age 68.7 ± 10.29 years), 657 strains were isolated, and the major causative bacteria detected were E. coli (61.5 %), E. faecalis (13.7 %), K. pneumoniae (5.2 %), and S. agalactiae (4.0 %). The sensitivities to fluoroquinolones (FQs) and cephems of E. coli isolated from premenopausal patients were both ≥90 %, while the sensitivities to FQs of E. coli isolated from postmenopausal patients were about 5 % lower. In regard to infection with quinolone-resistant E. coli (minimal inhibitory concentration of levofloxacin [LVFX] ≥4 μg/mL), significant risk factors were observed in patients with more than two episodes of cystitis within a year (p = 0.0002), patients to whom antibacterial agents were used previously for this episode of cystitis (p = 0.0175), and patients who had a history of FQ administration within 1 month. Although the species and distribution of causative bacteria of acute uncomplicated cystitis were the same regardless of the presence of menopause, the sensitivities to FQs of E. coli detected in postmenopausal patients were significantly lower than those in the premenopausal women. The major risk factors for infection with quinolone-resistant E. coli were a history of FQ administration and the morbidity of cystitis rather than the menopausal status. It was considered that taking an appropriate history including the morbidity of cystitis and history of FQ administration, and the appropriate selection of an antibacterial agent, would be important when empirical therapy is required.

Published
2012
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26. Japanese guideline for clinical research of antimicrobial agents on urogenital infections: the first edition.

Author

Yasuda M, Takahashi S, Kiyota H, Ishikawa K, Takahashi A, Yamamoto S, Arakawa S, Monden K, Muratani T, Hamasuna R, Hayami H, and Matsumoto T

Subjects
Bacterial Infections drug therapy, Biomedical Research standards, Female, Humans, Male, Specimen Handling, Urinary Tract Infections drug therapy, Anti-Infective Agents therapeutic use, Female Urogenital Diseases drug therapy, Male Urogenital Diseases drug therapy
Published
2011
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27. The nationwide study of bacterial pathogens associated with urinary tract infections conducted by the Japanese Society of Chemotherapy.

Author

Ishikawa K, Matsumoto T, Yasuda M, Uehara S, Muratani T, Yagisawa M, Sato J, Niki Y, Totsuka K, Sunakawa K, Hanaki H, Hattori R, Terada M, Kozuki T, Maruo A, Morita K, Ogasawara K, Takahashi Y, Matsuda K, Hirose T, Miyao N, Hayashi T, Takeyama K, Kiyota H, Tomita M, Yusu H, Koide H, Kimura S, Yanaoka M, Sato H, Ito T, Deguchi T, Fujimoto Y, Komeda H, Asano Y, Takahashi Y, Ishihara S, Arakawa S, Nakano Y, Tanaka K, Fujisawa M, Matsui T, Fujii A, Yamamoto S, Nojima M, Higuchi Y, Ueda Y, Kanamaru S, Monden K, Tsushima T, Seno Y, Tsugawa M, Takenaka T, Hamasuna R, Fujimoto N, Sho T, Takahashi K, Inatomi H, Takahashi N, Ikei Y, Hayami H, Yamane T, Nakagawa M, Kariya S, and Arima T

Subjects
Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents pharmacology, Enterobacteriaceae classification, Enterobacteriaceae drug effects, Enterococcus faecalis classification, Enterococcus faecalis drug effects, Female, Gram-Positive Bacterial Infections epidemiology, Humans, Japan epidemiology, Male, Microbial Sensitivity Tests, Middle Aged, Societies, Scientific, Urinary Tract Infections epidemiology, Enterobacteriaceae isolation & purification, Enterobacteriaceae Infections microbiology, Enterococcus faecalis isolation & purification, Gram-Positive Bacterial Infections microbiology, Urinary Tract Infections microbiology
Abstract

This study was conducted by the Japanese Society of Chemotherapy and is the first nationwide study on bacterial pathogens isolated from patients with urinary tract infections at 28 hospitals throughout Japan between January 2008 and June 2008. A total of 688 bacterial strains were isolated from adult patients with urinary tract infections. The strains investigated in this study are as follows: Enterococcus faecalis (n = 140), Escherichia coli (n = 255), Klebsiella pneumoniae (n = 93), Proteus mirabilis (n = 42), Serratia marcescens (n = 44), and Pseudomonas aeruginosa (n = 114). The minimum inhibitory concentrations of 39 antibacterial agents used for these strains were determined according to the Clinical and Laboratory Standards Institute (CLSI) manual. All Enterococcus faecalis strains were susceptible to ampicillin and vancomycin. Although a majority of the E. faecalis strains were susceptible to linezolid, 11 strains (7.8%) were found to be intermediately resistant. The proportions of fluoroquinolone-resistant Enterococcus faecalis, Escherichia coli, Proteus mirabilis, and S. marcescens strains were 35.7%, 29.3%, 18.3%, and 15.2%, respectively. The proportions of E. coli, P. mirabilis, K. pneumoniae, and S. marcescens strains producing extended-spectrum β-lactamase were 5.1%, 11.9%, 0%, and 0%, respectively. The proportions of Pseudomonas aeruginosa strains resistant to carbapenems, aminoglycosides, and fluoroquinolones were 9.2%, 4.4%, and 34.8%, respectively, and among them, 2 strains (1.8%) were found to be multidrug resistant. These data present important information for the proper treatment of urinary tract infections and will serve as a useful reference for periodic surveillance studies in the future.

Published
2011
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28. Activities of beta-lactams, fluoroquinolones, amikacin and fosfomycin alone and in combination against Pseudomonas aeruginosa isolated from complicated urinary tract infections.

Author

Hayami H, Goto T, Kawahara M, and Ohi Y

Abstract

Using the checkerboard titration method as well as the time-kill curve technique, we investigated the activities of beta-lactams, fluoroquinolones, amikacin, and fosfomycin alone and in combination against Pseudomonas aeruginosa isolated from patients with complicated urinary tract infections. In the checkerboard titration studies, none of 21 combinations demonstrated antagonism against 26 strains tested, and the mean fractional inhibitory concentration (FIC) indices for these combinations ranged between 0.4694 and 0.9828. Corresponding to the respective FIC indices, the bactericidal activity determined in combinations of meropenem with ciprofloxacin or amikacin and ceftazidime with ciprofloxacin at sub-minimum inhibitory concentrations (MICs) produced a great reduction in bacterial counts (>/=2 log10 CFU/ml) within 6 h of administration against most of the strains, including strains resistant to one or both drugs, and these synergistic effects were confirmed morphologically by scanning electron microscopy. In time-lag combinations, the first administration of ciprofloxacin or amikacin supplemented by meropenem with 1-h lag diminished bactericidal activity, in comparison with the simultaneous administration of the drugs. These results suggest that simultaneous combinations of beta-lactams with fluoroquinolones or amikacin may be useful alternatives for the treatment of serious infections due to P. aeruginosa.

Published
1999
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