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The resistance of Staphylococcus aureus (S. aureus) to antibiotics is an increasing problem. Clindamycin has been used as empiric therapy for the rising incidence of community-acquired methicillin-resistant S. aureus (MRSA). As such, the local rate of inducible resistance against clindamycin is an important consideration. This multicenter study was conducted to identify the incidence of inducible clindamycin resistance of S. aureus isolates in Tokyo, the most populous city in Japan. A total of 2408 adult and pediatric samples were collected from a university hospital and two pediatric hospitals between January 2011 and December 2011. Among the 2341 samples analyzed, the incidence of inducible clindamycin resistance in erythromycin-resistant and clindamycin-susceptible/intermediate isolates was found to be 91% (n = 585), a figure much higher compared to most reports from other countries. In conclusion, we found a very high rate of inducible clindamycin resistance in macrolide-resistant S. aureus isolates in our geographic area., (Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Background: Human parechovirus type 3 (HPeV3) infection can cause sepsis-like syndrome and meningoencephalitis in neonates and young infants. Although maculopapular rash is a reported clinical manifestation of HPeV3 infection, the frequency and detailed characteristics of rash in neonates and young infants with HPeV3 infection are unknown., Methods: We retrospectively reviewed the clinical characteristics of neonates and young infants who received a diagnosis of HPeV3 infection on the basis of real-time polymerase chain reaction analysis of serum and/or cerebrospinal fluid specimens at the National Center for Child Health and Development in Tokyo between November 2010 and September 2011., Results: Fifteen neonates and young infants were diagnosed as having HPeV3 infection; median age was 33 days (range: 10-81 days). The most common clinical presentation on admission was fever (80%), the median duration of which was 3 days (range: 1-4 days). Five (33%) children required admission to the intensive care unit for close observation, and 2 (13%) required mechanical ventilation for cardiovascular instability. After hospitalization, all children developed rash, mainly on the extremities, at a mean of 3 days (range: 1-5 days) after fever onset. The most striking finding was that 80% (12/15) of patients developed a distinctive palmar-plantar erythematous rash, which disappeared after a median of 3 days (range: 2-7 days). All patients were discharged from hospital without serious sequelae., Conclusions: Palmar-plantar erythema in febrile neonates and young infants may be a diagnostic clue of HPeV3 infection.