Epidemiological study of levofloxacin-resistant Streptococcus pneumoniae isolated from 2003 through 2006 in Japan
Abstract
We evaluated the usefulness of WHONET, free software from the World Health Organization (WHO), in a laboratory-based survey analyzing infectious disease, i.e., Streptococcus pneumoniae, and its antimicrobial susceptibility, i.e., to levofloxacin (LVFX), between 2003 and 2006 at 5 hospitals. The percentage of resistant strains (MIC > or = 8 microg/mL) isolated by the Maebashi Red Cross Hospital Laboratory between 2003 and 2005 was 3.8% (26/684 = number of resistant isolates/number of all isolates), significantly higher (p<0.001, Fisher's exact test) than the 0.5% (8/1717) recorded at 4 other hospital laboratories. In 2006 the Maebashi Red Cross Hospital Laboratory percentage of resistant strains was 0.9% (2/221) in the absence of intervention to reduce the percentage of resistant isolates, while that at 4 other hospital laboratories was 1.3% (9/ 717)--a difference not statistically significant (p = 0.574). Of resistant strains, 86% (24/28) came from patients older than 67 years and 71% (20/28) from outpatients or those newly hospitalized 1 or 2 days. Where and when pathogens are isolated are the two priority factors in epidemiological analysis. Superimposing plot of patient residences and isolated times of LVFX-resistant S. pneumoniae strains for each incidences showed no unusual trends in pathogen distribution. Analysis of possible multiple drug resistance for all LVFX-resistant S. pneumoniae isolates, i.e., resistance profile determination, indicated that no strain isolated…
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