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Antibiotic susceptibility in relation to genotype of Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae responsible for community-acquired pneumonia in children

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Journal of Infection and Chemotherapy

Abstract

Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae are the main pathogens causing community-acquired pneumonia (CAP). We identified S. pneumoniae (n = 241), H. influenzae (n = 123), and M. pneumoniae (n = 54) as causative pathogens from clinical findings and blood tests from pediatric CAP patients (n = 903) between April 2008 and April 2009. Identification of genes mediating antimicrobial resistance by real-time PCR was performed for all isolates of these three pathogens, as was antibiotic susceptibility testing using an agar dilution method or broth microdilution method. The genotypic (g) resistance rate was 47.7 % for penicillin-resistant S. pneumoniae (gPRSP) possessing abnormal pbp1a, pbp2x, and pbp2b genes, 62.6 % for β-lactamase-nonproducing, ampicillin-resistant (gBLNAR) H. influenzae possessing the amino acid substitutions Ser385Thr and Asn526Lys, and 44.4 % for macrolide-resistant M. pneumoniae (gMRMP) possessing a mutation of A2063G, A2064G, or C2617A. Serotype 6B (20.3 %) predominated in S. pneumoniae, followed by 19F (15.4 %), 14 (14.5 %), 23F (12.0 %), 19A (6.2 %), and 6C (5.4 %). Coverage for the isolates by heptavalent pneumococcal conjugate vaccine (PCV7) and PCV13, respectively, was calculated as 68.5 and 80.9 %. A small number of H. influenzae were identified as type b (6.5 %), type e (0.8 %), or type f (0.8 %); all others were nontypeable. Proper use of antibiotics based on information about resistance in CAP pathogens is required to control rapid increases in resistance. Epidemiological surveillance of pediatric patients also is needed to assess the effectiveness of PCV7 and Hib vaccines after their introduction in Japan.

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Acknowledgments

We thank the members of the Acute Respiratory Diseases Study Group: Drs. Takeshi Tajima and Eiichi Nakayama (Hakujikai Memorial Hospital), Reiko Takayanagi, Shinobu Ishizawa, Mika Numata, and Michiyo Kojima (Tohoku Rosai Hospital), Naohisa Kawamura and Koichi Shimizu (Osaka Rosai Hospital), Naruhiko Ishiwada and Junko Tanaka (Chiba University Hospital), Yoshitake Sato (Health Insurance Society of General Ota Hospital, Fuji Heavy Industries Ltd.), Kazunobu Ouchi (Kawasaki Medical School Hospital), Tsunekazu Haruta and Takuya Tamura (Kobe City Medical Center General Hospital), and Tomohiro Oishi (Niigata University Medical and Dental Hospital). This study was supported in part by a grant under the category “Research on Emerging and Re-emerging Infectious Diseases” (numbers H21-002 and H22-013) from the Japanese Ministry of Health, Labour and Welfare (to K. Ubukata).

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Authors and Affiliations

  1. Laboratory of Molecular Epidemiology for Infectious Agents, Kitasato Institute for Life Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan

    Miyuki Morozumi, Naoko Chiba, Takafumi Okada & Kimiko Ubukata

  2. Department of Pediatrics, National Hospital Organization Tokyo Medical Center, Tokyo, Japan

    Takafumi Okada, Keita Matsubara & Satoshi Iwata

  3. Department of Pediatrics, Asahikawa Kosei Hospital, Hokkaido, Japan

    Hiroshi Sakata

  4. Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan

    Satoshi Iwata

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  1. Miyuki Morozumi
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  2. Naoko Chiba
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  3. Takafumi Okada
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  4. Hiroshi Sakata
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  5. Keita Matsubara
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  7. Kimiko Ubukata
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Correspondence to Kimiko Ubukata.

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Morozumi, M., Chiba, N., Okada, T. et al. Antibiotic susceptibility in relation to genotype of Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae responsible for community-acquired pneumonia in children. J Infect Chemother 19, 432–440 (2013). https://doi.org/10.1007/s10156-012-0500-x

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  • DOI: https://doi.org/10.1007/s10156-012-0500-x

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