{"title":"儿科鼻窦感染病原菌的流行病学和耐药性：日本耳鼻喉科门诊的回顾性研究（2023-2025）。","authors":"Shiori Kitaya, Toshiaki Kikuchi, Kazuhiro Nomura, Yuri Nomura, Ryoukichi Ikeda, Hajime Kanamori, Yukio Katori","doi":"10.3389/fcimb.2025.1662544","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong><i>Haemophilus influenzae</i> and <i>Streptococcus pneumoniae</i> are two of the major pathogens responsible for pediatric rhinosinusitis. Rising antimicrobial resistance (AMR) and pneumococcal serotype replacement have complicated treatment decisions. This study aimed to investigate bacterial distribution and AMR patterns in nasal discharge samples from children at a Japanese otolaryngology clinic.</p><p><strong>Methods: </strong>We conducted a retrospective study at an otolaryngology clinic in Sendai, Japan, from February 2023 to March 2025. A total of 2009 nasal discharge specimens were analyzed. Bacterial identification and antimicrobial susceptibility testing were performed according to Clinical and Laboratory Standards Institute guidelines. <i>H. influenzae</i> and <i>S. pneumoniae</i> were phenotypically classified and stratified by age (0-2, 3-5, and 6-13 years). Age-group comparisons were performed using Fisher's exact test with Holm correction.</p><p><strong>Results: </strong>Pathogens were detected in 1862 samples (92.7%). The most frequently isolated organisms were <i>Moraxella catarrhalis</i> (30.9%), <i>H. influenzae</i> (23.0%), and <i>S. pneumoniae</i> (20.6%). Among the 697 <i>H. influenzae</i> isolates, 44.8% were ampicillin-resistant, and 31.3% of all isolates were β-lactamase-negative ampicillin-resistant (BLNAR) strains. Some BLNAR strains exhibited reduced susceptibility to amoxicillin-clavulanic acid (MIC<sub>90</sub> = 8 μg/mL). Cefotaxime, cefditoren, and levofloxacin remained highly active. Among the 625 <i>S. pneumoniae</i> isolates, 66.6% were penicillin-susceptible, 31.0% were intermediate, and 2.4% were resistant; resistance to clarithromycin was observed in 84.3% of isolates. The prevalence of <i>Staphylococcus aureus</i> increased with age, with 25% of isolates in the 6-13-year group identified as methicillin-resistant.</p><p><strong>Conclusion: </strong><i>H. influenzae</i> and <i>S. pneumoniae</i> remain key pathogens in pediatric rhinosinusitis and exhibit high AMR rates. Age-specific trends, including increased methicillin-resistant <i>S. aureus</i> in older children, should guide empiric therapy. Ongoing AMR surveillance and culture-based management are essential.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"15 ","pages":"1662544"},"PeriodicalIF":4.8000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477215/pdf/","citationCount":"0","resultStr":"{\"title\":\"Epidemiology and antimicrobial resistance of pathogens in pediatric sinus infections: a retrospective study at a Japanese otolaryngology clinic (2023-2025).\",\"authors\":\"Shiori Kitaya, Toshiaki Kikuchi, Kazuhiro Nomura, Yuri Nomura, Ryoukichi Ikeda, Hajime Kanamori, Yukio Katori\",\"doi\":\"10.3389/fcimb.2025.1662544\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong><i>Haemophilus influenzae</i> and <i>Streptococcus pneumoniae</i> are two of the major pathogens responsible for pediatric rhinosinusitis. Rising antimicrobial resistance (AMR) and pneumococcal serotype replacement have complicated treatment decisions. This study aimed to investigate bacterial distribution and AMR patterns in nasal discharge samples from children at a Japanese otolaryngology clinic.</p><p><strong>Methods: </strong>We conducted a retrospective study at an otolaryngology clinic in Sendai, Japan, from February 2023 to March 2025. A total of 2009 nasal discharge specimens were analyzed. Bacterial identification and antimicrobial susceptibility testing were performed according to Clinical and Laboratory Standards Institute guidelines. <i>H. influenzae</i> and <i>S. pneumoniae</i> were phenotypically classified and stratified by age (0-2, 3-5, and 6-13 years). Age-group comparisons were performed using Fisher's exact test with Holm correction.</p><p><strong>Results: </strong>Pathogens were detected in 1862 samples (92.7%). The most frequently isolated organisms were <i>Moraxella catarrhalis</i> (30.9%), <i>H. influenzae</i> (23.0%), and <i>S. pneumoniae</i> (20.6%). Among the 697 <i>H. influenzae</i> isolates, 44.8% were ampicillin-resistant, and 31.3% of all isolates were β-lactamase-negative ampicillin-resistant (BLNAR) strains. Some BLNAR strains exhibited reduced susceptibility to amoxicillin-clavulanic acid (MIC<sub>90</sub> = 8 μg/mL). Cefotaxime, cefditoren, and levofloxacin remained highly active. Among the 625 <i>S. pneumoniae</i> isolates, 66.6% were penicillin-susceptible, 31.0% were intermediate, and 2.4% were resistant; resistance to clarithromycin was observed in 84.3% of isolates. The prevalence of <i>Staphylococcus aureus</i> increased with age, with 25% of isolates in the 6-13-year group identified as methicillin-resistant.</p><p><strong>Conclusion: </strong><i>H. influenzae</i> and <i>S. pneumoniae</i> remain key pathogens in pediatric rhinosinusitis and exhibit high AMR rates. Age-specific trends, including increased methicillin-resistant <i>S. aureus</i> in older children, should guide empiric therapy. Ongoing AMR surveillance and culture-based management are essential.</p>\",\"PeriodicalId\":12458,\"journal\":{\"name\":\"Frontiers in Cellular and Infection Microbiology\",\"volume\":\"15 \",\"pages\":\"1662544\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477215/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Cellular and Infection Microbiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fcimb.2025.1662544\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Cellular and Infection Microbiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fcimb.2025.1662544","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Epidemiology and antimicrobial resistance of pathogens in pediatric sinus infections: a retrospective study at a Japanese otolaryngology clinic (2023-2025).
Introduction: Haemophilus influenzae and Streptococcus pneumoniae are two of the major pathogens responsible for pediatric rhinosinusitis. Rising antimicrobial resistance (AMR) and pneumococcal serotype replacement have complicated treatment decisions. This study aimed to investigate bacterial distribution and AMR patterns in nasal discharge samples from children at a Japanese otolaryngology clinic.
Methods: We conducted a retrospective study at an otolaryngology clinic in Sendai, Japan, from February 2023 to March 2025. A total of 2009 nasal discharge specimens were analyzed. Bacterial identification and antimicrobial susceptibility testing were performed according to Clinical and Laboratory Standards Institute guidelines. H. influenzae and S. pneumoniae were phenotypically classified and stratified by age (0-2, 3-5, and 6-13 years). Age-group comparisons were performed using Fisher's exact test with Holm correction.
Results: Pathogens were detected in 1862 samples (92.7%). The most frequently isolated organisms were Moraxella catarrhalis (30.9%), H. influenzae (23.0%), and S. pneumoniae (20.6%). Among the 697 H. influenzae isolates, 44.8% were ampicillin-resistant, and 31.3% of all isolates were β-lactamase-negative ampicillin-resistant (BLNAR) strains. Some BLNAR strains exhibited reduced susceptibility to amoxicillin-clavulanic acid (MIC90 = 8 μg/mL). Cefotaxime, cefditoren, and levofloxacin remained highly active. Among the 625 S. pneumoniae isolates, 66.6% were penicillin-susceptible, 31.0% were intermediate, and 2.4% were resistant; resistance to clarithromycin was observed in 84.3% of isolates. The prevalence of Staphylococcus aureus increased with age, with 25% of isolates in the 6-13-year group identified as methicillin-resistant.
Conclusion: H. influenzae and S. pneumoniae remain key pathogens in pediatric rhinosinusitis and exhibit high AMR rates. Age-specific trends, including increased methicillin-resistant S. aureus in older children, should guide empiric therapy. Ongoing AMR surveillance and culture-based management are essential.
期刊介绍：
Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.
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