[Detection methods and changes in metallo-beta-lactamase-producing Gram-negative rod isolates at Nagasaki University Hospital from 1991 to 2005].

Since plasmid-mediated metallo-beta-lactamase (MBL)-producing Pseudimonas aeruginosa was reported in Japan, MBL-producing Gram-negative rods (GNRs) have emerged worldwide. We developed a way to detect MBL-producing GNRs in routine examination using broth microdilution with the MBL inhibitor sodium mercaptoacetate (SMA) in frozen plates. Between 1996 and 2005, we evaluated this and other methods, including broth microdilution with another MBL inhibitor dipicolinic acid (DPA) in dry plates, conventional PCR, and a combined simple DNA preparation and enzymatic PCR product detection.

The first telithromycin-resistant Streptococcus pneumoniae isolate in Japan associated with erm(B) and mutations in 23S rRNA and riboprotein L4.

This report presents the case of a patient associated with a Streptococcus pneumoniae isolate that was resistant to a new ketolide antibiotic, telithromycin (minimum inhibitory concentration: 4 microg/ml). The patient, a 61-year-old female with bronchiectasis, was treated with 200-400 mg of clarithromycin daily for 6 years until the isolation of the resistant strain but without prior exposure to telithromycin. The strain was isolated from her sputum but not from the nasopharynx.