1887

Abstract

strains with low susceptibility to quinolones have recently emerged in the paediatric field in Japan. These strains are judged as ‘susceptible’ in routine susceptibility tests, although they may survive after quinolone treatment. Therefore, we aimed to construct a simple and cost-effective identification method for low-susceptibility strains using disc diffusion assays.

A total of 33 clinical isolates and a control strain were used. For the disc diffusion assay, levofloxacin, norfloxacin, nalidixic acid and pipemidic acid were employed. Correlations between the inhibition zone diameter and amino acid substitutions were evaluated.

All of the tested strains formed clear inhibition zones on both levofloxacin and norfloxacin discs. By contrast, none of the low-susceptibility strains showed inhibition zones against nalidixic acid, while the low-susceptibility strains with amino acid substitutions in both GyrA and ParC did not show inhibition zones against pipemidic acid discs, indicating that low-susceptibility strains can be detected with high sensitivity and specificity by the presence or absence of inhibition zones for earlier quinolones.

A disc diffusion test combining results from nalidixic acid and pipemidic acid can detect low-susceptibility strains harbouring amino acid substitutions without the need for genetic analysis. This test can help reduce inappropriate and unnecessary fluoroquinolone use.

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2019-08-01
2024-12-01
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References

  1. Tristram S, Jacobs MR, Appelbaum PC. Antimicrobial resistance in Haemophilus influenzae . Clin Microbiol Rev 2007; 20:368–389 [View Article]
    [Google Scholar]
  2. Ubukata K, Shibasaki Y, Yamamoto K, Chiba N, Hasegawa K et al. Association of amino acid substitutions in penicillin-binding protein 3 with beta-lactam resistance in beta-lactamase-negative ampicillin-resistant Haemophilus influenzae . Antimicrob Agents Chemother 2001; 45:1693–1699 [View Article]
    [Google Scholar]
  3. Tanaka T, Oishi T, Miyata I, Wakabayashi S, Kono M et al. Macrolide-resistant Mycoplasma pneumoniae infection, Japan, 2008–2015. Emerg Infect Dis 2017; 23:1703–1706 [View Article]
    [Google Scholar]
  4. Wajima T, Chiba N, Morozumi M, Shouji M, Sunaoshi K et al. Prevalence of macrolide resistance among group A streptococci isolated from pharyngotonsillitis. Microb Drug Resist 2014; 20:431–435 [View Article]
    [Google Scholar]
  5. Wajima T, Seyama S, Nakamura Y, Kashima C, Nakaminami H et al. Prevalence of macrolide-non-susceptible isolates among β-lactamase-negative ampicillin-resistant Haemophilus influenzae in a tertiary care hospital in Japan. J Glob Antimicrob Resist 2016; 6:22–26 [View Article]
    [Google Scholar]
  6. Seyama S, Wajima T, Yanagisawa Y, Nakaminami H, Ushio M et al. Rise in Haemophilus influenzae with reduced quinolone susceptibility and development of a simple screening method. Pediatr Infect Dis J 2017; 36:263–266 [View Article]
    [Google Scholar]
  7. Takeuchi N, Ohkusu M, Hoshino T, Naito S, Takaya A et al. Emergence of quinolone-resistant strains in Streptococcus pneumoniae isolated from paediatric patients since the approval of oral fluoroquinolones in Japan. J Infect Chemother 2017; 23:218–223 [View Article]
    [Google Scholar]
  8. CLSI Performance Standards for Antimicrobial Susceptibility Testing, Twenty-Fifth informational supplement. Document M100–S25 . Wayne, PA: CLSI; 2015
    [Google Scholar]
  9. Tanaka E, Hara N, Wajima T, Ochiai S, Seyama S et al. Emergence of Haemophilus influenzae with low susceptibility to quinolones and persistence in tosufloxacin treatment. J Glob Antimicrob Resist 2019 09 Feb 2019 [View Article]
    [Google Scholar]
  10. McDonald LC, Chen FJ, Lo HJ, Yin HC, Lu PL et al. Emergence of reduced susceptibility and resistance to fluoroquinolones in Escherichia coli in Taiwan and contributions of distinct selective pressures. Antimicrob Agents Chemother 2001; 45:3084–3091 [View Article]
    [Google Scholar]
  11. Pérez-Vázquez M, Román F, Aracil B, Cantón R, Campos J. Laboratory detection of Haemophilus influenzae with decreased susceptibility to nalidixic acid, ciprofloxacin, levofloxacin, and moxifloxacin due to gyrA and parC mutations. J Clin Microbiol 2004; 42:1185–1191 [View Article]
    [Google Scholar]
  12. Puig C, Tirado-Vélez JM, Calatayud L, Tubau F, Garmendia J et al. Molecular characterization of fluoroquinolone resistance in nontypeable Haemophilus influenzae clinical isolates. Antimicrob Agents Chemother 2015; 59:461–466 [View Article]
    [Google Scholar]
  13. Shimizu M, Takase Y, Nakamura S, Katae H, Minami A. Pipemidic acid, a new antibacterial agent active against Pseudomonas aeruginosa: in vitro properties. Antimicrob Agents Chemother 1975; 8:132–138 [View Article]
    [Google Scholar]
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