title: Nationwide survey of Streptococcus pneumoniae drug resistance in the pediatric field in Japan.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Drug-Resistant Pathogen Surveillance Group in Pediatric Infectious Disease, Japan.|Department of Pediatrics, Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Okada
authors.affiliation: Drug-Resistant Pathogen Surveillance Group in Pediatric Infectious Disease, Japan.|Department of Pediatrics, Fuji Heavy Industries Health Insurance Society, Ota Memorial Hospital, Ota, Gunma, Japan.
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Drug-Resistant Pathogen Surveillance Group in Pediatric Infectious Disease, Japan.|Department of Pediatrics, Saitama Sekishinkai Hospital, Sayama, Saitama, Japan.
authors.forename: Yoshikiyo
authors.initials: Y
authors.lastname: Toyonaga
authors.affiliation: Kitasato Institute, Kitasato University Research Center for Anti-infectious Drugs, Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hanaki
authors.affiliation: Drug-Resistant Pathogen Surveillance Group in Pediatric Infectious Disease, Japan.|Kitasato Institute, Kitasato University Research Organization for Infection Control Sciences, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sunakawa
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Streptococcus pneumoniae; interaction; pediatric infectious disease; surveillance; susceptibility