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首页> 外文期刊>Journal of infection and chemotherapy: official journal of the Japan Society of Chemotherapy >Emergence of quinolone-resistant strains in Streptococcus pneumoniae isolated from paediatric patients since the approval of oral fluoroquinolones in Japan
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Emergence of quinolone-resistant strains in Streptococcus pneumoniae isolated from paediatric patients since the approval of oral fluoroquinolones in Japan

机译：自日本口服氟喹诺酮类自氟喹诺酮类以来从儿科患者中分离出血肺炎链球菌肺炎链球菌抗菌菌菌株的出现

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摘要

Tosufloxacin (TFLX) is a fluoroquinolone antimicrobial agent. TFLX granules for children were initially released in Japan in 2010 to treat otitis media and pneumonia caused by drug-resistant bacteria, e.g. penicillin-resistant Streptococcus pneumoniae and beta-lactamase-negative, ampicillin-resistant Haemophilus influenzae. The evolution of bacterial resistance since TFLX approval is not known. To clarify the influence of quinolones administered to children since their approval, we examined the resistance mechanism of TFLX-resistant S. pneumoniae isolated from paediatric patients as well as patient clinical characteristics. TFLX-resistant strains (MIC >= 2 mg/L) were detected among clinical isolates of S. pneumoniae derived from children (<= 15 years old) between 2010 and 2014. These strains were characterised based on quinolone resistance-determining regions (QRDRs), i.e. gyrA, gyrB, parC, and parE. In addition, the antimicrobial susceptibility, serotype, and multilocus sequence type of strains were determined, pulsed-field gel electrophoresis was performed, and patient clinical characteristics based on medical records were assessed for cases with underling TFLX-resistant strains. Among 1168 S. pneumoniae isolates, two TFLX-resistant strains were detected from respiratory specimens obtained from paediatric patients with frequent exposure to TFLX. Both strains had mutations in the QRDRs of gyrA and parC. One case exhibited gradual changes in the QRDR during the clinical course. This is the first study of quinolone-resistant S. pneumoniae isolated from children, including clinical data, in Japan. These data may help prevent increases in infections of quinolone-resistant S. pneumoniae in children; specifically, the results emphasise the importance of administering fluoroquinolones only in appropriate cases. (C) 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
机译：Tosufloxacin（TFLX）是氟代喹啉醇抗微生物剂。儿童TFLX颗粒在2010年最初在日本释放，以治疗由耐药细菌引起的中耳炎培养基和肺炎，例如，青霉素抗性链球菌肺炎料和β-内酰胺酶阴性，氨苄青霉素的嗜血杆菌流感。由于TFLX批准以来的细菌抗性的演变是未知的。为了澄清以来批准给予儿童喹诺酮类的影响，我们研究了从儿科患者分离的TFLX抗性S.肺炎的抗性机制以及患者的临床特征。在2010年至2010年间的儿童（<= 15岁）源自儿童（<= 15岁）的临床分离物中检测到TFLX抗性菌株（MIC> = 2mg / L）。基于喹啉抗性确定区域的这些菌株表征（QRDRS ），即Gyra，Gyrb，Parc和Pare。此外，确定了抗微生物敏感性，血清型和多层序列类型的菌株，进行脉冲场凝胶电泳，并评估基于TFLX耐药菌株的病例的基于病历的患者临床特征。在1168秒的肺炎群分离物中，从常常暴露于TFLX的小儿患者获得的呼吸样品中检测到两种TFLX抗性菌株。两种菌株在Gyra和Parc的QRDR中具有突变。在临床课程期间，一个案例表现出QRDR的逐步变化。这是从儿童分离的喹诺酮抗性S.肺炎的第一次研究，包括临床数据，在日本。这些数据可能有助于防止儿童喹诺酮类肺炎肺炎的感染增加;具体地，结果强调仅在适当的情况下施用氟喹诺酮酮的重要性。 （c）2017日本化疗学会和日本传染病协会。 elsevier有限公司出版。保留所有权利。

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