PROTEKT 1999-2000: a multicentre study of the antimicrobial susceptibility of respiratory tract pathogens in Japan.

DESIGN

A six-centre study in Japan during the winter of 1999-2000 assessed the in vitro activity of >20 antimicrobial agents against the common respiratory pathogens Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, and Moraxella catarrhalis. The minimum inhibitory concentrations (MIC) of each antimicrobial was determined against these isolates using National Committee for Clinical Laboratory Standards (NCCLS) methodology.

RESULTS

Among S. pneumoniae isolates, 44.5% were penicillin resistant. The macrolide resistance rate was 77.9% with 90.5% of penicillin-resistant strains also being macrolide resistant. Resistance mechanisms in macrolide-resistant isolates were identified as mef(A) or erm(B) in 42.5% and 52.5%, respectively. Of the fluoroquinolone-resistant isolates (1.3%), most were also penicillin and macrolide resistant. All strains were inhibited by telithromycin at <or=1mg/L. Among S. pyogenes isolates, erythromycin resistance was 17.5% overall but showed considerable variation among the six centres. For H. influenzae, 8.5% produced beta-lactamase and a single beta-lactamase-negative, ampicillin-resistant isolate (0.36%) was obtained, and there was no fluoroquinolone resistance. All isolates were susceptible to telithromycin. Most antimicrobials showed good activity against M. catarrhalis, although 96.7% were beta-lactamase positive.

CONCLUSION

The prevalence of antimicrobial resistance to macrolides, penicillin and the fluoroquinolones among the common respiratory pathogens is high in Japan.