The Fifth Nationwide Survey of Clinical Isolates from Patients with Otolaryngological Field Infections

Abstract

With the cooperation of the otorhinolaryngological departments at 29 universities in Japan, as well as their 26 affiliated hospitals and practitioners, we conducted the fifth national survey (The first survey conducted by The Japanese surveillance committee, consisting of the Japanese Society of Chemotherapy, Japanese Association for Infectious Disease, and Japanese Society for Clinical Microbiology) to investigate the trends of bacterial isolates and bacterial sensitivity in otorhinolaryngological major infections.

The subjects comprised patients with acute purulent otitis media (185 cases), chronic otitis media (119 cases), acute sinusitis (128 cases), chronic sinusitis (92 cases), acute tonsillitis (116 cases), and peritonsillar abscess (89 cases) who presented to the medical institutions participating in the survey from January 2011 to June 2012. Using specimens obtained from the patients, bacteria were identified by culture and drug sensitivity was measured.

S. pneumoniae and H. influenzae were mainly isolated from patients with acute purulent otitis media and acute sinusitis, and frequency of isolation of S. aureus was decreasing in the recent surveys. Streptococcus spp. (including S. pyogenes) was mainly isolated from patients with acute tonsillitis. Anaerobes (Peptostreptococcus spp., Prevotella spp. and Fusobacterium spp. etc.) were mainly isolated from patients with peritonsillar abscess, and frequencies of isolation of anaerobes in the recent surveys were markedly higher than observed in the former surveys.

Among 112 strains of S. aureus isolated in the present survey, 28 (25.9%) were MRSA. Among 113 strains of S. pneumoniae isolated, 41 (36.8%) were PISP and 14 (12.3%) were PRSP. Among 106 strains of H. influenzae isolated, 38 (35.8%) were BLNAR, and 16 (15.1%) each were BLPAR and BLNAI, respectively. Frequency of isolation of these drug resistant bacteria was higher in patients aged 5 years or younger than in other age groups. Compared with the result of the previous surveys, frequencies of isolation of MRSA, resistant S. pneumoniae (PISP and PRSP), resistant H. influenzae (mainly BLNAR), and ABPC resistant M. catarrhalis are increasing recently.

It is considered necessary to take measures to promote the appropriate use of antibiotics in order to prevent the increase of resistant bacteria.