Nationwide survey of Streptococcus pneumoniae drug resistance in the pediatric field in Japan.
BACKGROUND
Streptococcus pneumoniae is a major causative pathogen of pneumonia in children. The Drug-Resistant Pathogen Surveillance Group in Pediatric Infectious Disease conducted a nationwide surveillance of S. pneumoniae in 2000-2001, 2004, 2007, 2010 and 2012, and investigated changes in drug resistance of S. pneumoniae.


METHODS
All strains of S. pneumoniae were isolated from clinical specimens collected from pediatric patients. The minimun inhibitory concentration was measured and the strains were classified according to the Clinical Laboratory Standards Institute criteria. The isolation rates of penicillin-intermediate resistant S. pneumoniae (PISP) and penicillin-resistant S. pneumoniae (PRSP) were compared based on seven patient factors. Logistic regression analysis was also performed.


RESULTS
The sum of the isolation rates for PISP and PRSP for each period was 64.6%, 67.0%, 56.2%, 76.9% and 49.5%, respectively. Among the patient factors, age category 1 (<3 years, ≥3 years), age category 2 (infant, toddler and preschooler, schoolchild), siblings (absence, presence), and pre-treatment with antimicrobial agents (absence, presence) were associated with significant differences in the isolation rate of PISP + PRSP. An interaction was observed between pre-treatment with antimicrobial agents and schoolchild, and the isolation rate of PISP + PRSP was higher in patients with both pre-treatment with antimicrobial agents and schoolchild.


CONCLUSION
Although some changes were observed in the rate of resistance of S. pneumoniae, an increasing trend was not observed. Both pre-treatment with antimicrobial agents and age were associated with resistance, and an interaction was observed between pre-treatment with antimicrobial agents and schoolchild.
['Okada|Takafumi|T|', 'Sato|Yoshitake|Y|', 'Toyonaga|Yoshikiyo|Y|', 'Hanaki|Hideaki|H|', 'Sunakawa|Keisuke|K|']
D000900:Anti-Bacterial Agents D002648:Child D002675:Child, Preschool D024881:Drug Resistance, Bacterial D005260:Female D006801:Humans D015994:Incidence D007223:Infant D007564:Japan D008297:Male D008826:Microbial Sensitivity Tests D011008:Pneumococcal Infections D013296:Streptococcus pneumoniae
Streptococcus pneumoniae surveillance pediatric infectious disease interaction susceptibility