JAC © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved
Supplement |
Distribution across the USA of macrolide resistance and macrolide resistance mechanisms among Streptococcus pneumoniae isolates collected from patients with respiratory tract infections: PROTEKT US 2001–2002
1 GR Micro Ltd, 7–9 William Road, London NW1 3ER, UK; 2 Carolinas Medical Center, Charlotte, NC, USA
* Corresponding author. Tel: +44-20-7388-7320; Fax: +44-20-7388-7324; Email: d.farrell{at}grmicro.co.uk
Abstract
Background: Resistance to the macrolides has increased rapidly among isolates of Streptococcus pneumoniae from community-acquired respiratory tract infections (CARTIs).
Methods: A total of 10 012 S. pneumoniae isolates were submitted from 46 US states and the territory of Puerto Rico in the PROTEKT US Year 2 (2001–2002) surveillance study. Antimicrobial susceptibilities were determined according to NCCLS guidelines and genes encoding common macrolide resistance mechanisms were sought by PCR.
Results: Overall, 27.9% (n=2793) of S. pneumoniae isolates were macrolide (erythromycin) resistant; the highest prevalence was recorded in Louisiana (48.2%). Of the 2738 genotyped macrolide-resistant S. pneumoniae, 68.7% possessed mef(A) (state range: Delaware 40.0%–Georgia 84.8%), 16.8% of isolates harboured erm(B) (Georgia 6.1%–Idaho and Rhode Island both 36.4%) and 12.2% possessed erm(B) + mef(A) (Arkansas and Rhode Island 0%–South Dakota 32.9%). Five isolates possessed an erm(A) subclass erm(TR) gene (from California, Illinois, Missouri, Pennsylvania and Virginia), while the mechanisms for 56 isolates were not definable by the methods used in this study. Susceptibility to telithromycin was high, irrespective of macrolide resistance mechanism, with 
96.4% of the macrolide-resistant isolates susceptible.
Conclusions: The prevalence of macrolide resistance and the resistance mechanisms among S. pneumoniae isolates are highly variable among the US states. Telithromycin may represent an effective treatment option for CARTIs caused by macrolide-resistant pneumococci.
Keywords: macrolide-resistant , S. pneumoniae , telithromycin
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L. Lawrence, P. Danese, J. DeVito, F. Franceschi, and J. Sutcliffe In Vitro Activities of the Rx-01 Oxazolidinones against Hospital and Community Pathogens Antimicrob. Agents Chemother., May 1, 2008; 52(5): 1653 - 1662. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. K. Wierzbowski, K. Nichol, N. Laing, T. Hisanaga, A. Nikulin, J. A. Karlowsky, D. J. Hoban, and G. G. Zhanel Macrolide resistance mechanisms among Streptococcus pneumoniae isolated over 6 years of Canadian Respiratory Organism Susceptibility Study (CROSS) (1998 2004) J. Antimicrob. Chemother., October 1, 2007; 60(4): 733 - 740. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Fukuda, K. Yanagihara, Y. Higashiyama, Y. Miyazaki, Y. Hirakata, H. Mukae, K. Tomono, Y. Mizuta, K. Tsukamoto, and S. Kohno Effects of macrolides on pneumolysin of macrolide-resistant Streptococcus pneumoniae Eur. Respir. J., May 1, 2006; 27(5): 1020 - 1025. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. D. Ambrose, R. Nisbet, and D. S. Stephens Macrolide Efflux in Streptococcus pneumoniae Is Mediated by a Dual Efflux Pump (mel and mef) and Is Erythromycin Inducible Antimicrob. Agents Chemother., October 1, 2005; 49(10): 4203 - 4209. [Abstract] [Full Text] [PDF]
|
|