Trends in anti-bacterial resistance among Streptococcus pneumoniae isolated in the USA, 2000–2003: PROTEKT US years 1–3

• Published in: The Journal of infection 2005-12, Vol.51 (5), p.355-363
• Main Authors: Jenkins, Stephen G., Farrell, David J., Patel, Manish, Lavin, Bruce S.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anti-Bacterial Agents - pharmacology; Bacterial diseases; Bacterial Proteins - genetics; Biological and medical sciences; Child; Child, Preschool; Drug Resistance, Multiple, Bacterial - genetics; Erythromycin; Female; General aspects; Genotype; Human bacterial diseases; Humans; Infant; Infant, Newborn; Infectious diseases; Ketolides - pharmacology; Levofloxacin; Macrolide; Macrolides - pharmacology; Male; Medical sciences; Membrane Proteins - genetics; Methyltransferases - genetics; Microbial Sensitivity Tests; Middle Aged; Multidrug resistance; Penicillin; Pneumococcal Infections - drug therapy; Pneumococcal Infections - microbiology; Respiratory Tract Infections - drug therapy; Respiratory Tract Infections - microbiology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Streptococcus pneumoniae; Streptococcus pneumoniae - drug effects; Streptococcus pneumoniae - genetics; Surveillance; Telithromycin; United States
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2005.04.015

To determine geographic and temporal trends in anti-bacterial resistance among Streptococcus pneumoniae isolated from patients with respiratory tract infections as part of the PROTEKT US surveillance study (2000–2003). From 2000 to 2003, 31 001 isolates of S. pneumoniae were collected. Anti-bacterial minimum inhibitory concentrations were determined at a central laboratory using the CLSI broth microdilution method. Macrolide resistance genotypes were determined by PCR. Overall, 29.4, 22.5, 0.9, and 0.02% of S. pneumoniae isolates were resistant to erythromycin, penicillin, levofloxacin, and telithromycin, respectively, with considerable regional variability. Multidrug resistance was stable at approx. 31%. Among macrolide-resistant isolates, mef(A) was the most prevalent resistance gene identified; however, the percentage of isolates with this gene decreased from 68.8% (2000) to 63.9% (2003), while the prevalence of isolates containing both the erm(B) and mef(A) genes increased (2000, 9.7%; 2003, 16.4%). Over 90% of these erm(B)+ mef(A)-positive isolates were also resistant to penicillin, tetracycline, or trimethoprim-sulfamethoxazole, while 98.6% were susceptible to levofloxacin and 99.1% were susceptible to telithromycin. Penicillin and erythromycin resistance among isolates of S. pneumoniae from the U.S.A. remained high over the 3 years of the study. Telithromycin demonstrated potent in vitro activity against pneumococcal strains.