Increasing prevalence of antimicrobial resistance among isolates of Streptococcus pneumoniae from the PROTEKT surveillance study, and compatative in vitro activity of the ketolide, telithromycin
Increasing prevalence of antimicrobial resistance among isolates of Streptococcus pneumoniae from the PROTEKT surveillance study, and compatative in vitro activity of the ketolide, telithromycin
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DOI：
10.1093/jac/dkf808
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发表时间：
2002-09-01
影响因子：
5.2
通讯作者：
Rodloff, A
中科院分区：
文献类型：
--
作者：
Felmingham, D;Reinert, RR;Rodloff, A
使用NCCLS检测方法和解释标准，确定了PROTEKT（氯胺酮泰利霉素的前瞻性耐药微生物追踪和流行病学）监测研究（1999-2000）中检查的肺炎链球菌分离株对一系列抗菌剂的耐药性流行率。从25个国家的69个中心收集的3362株肺炎球菌分离株中，22.1%对青霉素G耐药，亚洲（53.4%）、法国（46.2%）和西班牙（42.1%）的分离株耐药率最高。红霉素A耐药发生在31.1%的分离株中，亚洲（79.6%）、法国（57.6%）、匈牙利（55.6%）和意大利（42.9%）的发生率最高。观察到青霉素G（荷兰0%;韩国71.5%）和红霉素A（瑞典4.7%;韩国87.6%）耐药的流行率存在显著的地理差异。总体而言，亚洲的耐药发生率最高，19种抗菌药物中只有8种（复方阿莫西林、利奈唑胺、万古霉素、替考拉宁、奎奴普汀/达福普汀、左氧氟沙星、阿托沙星和泰利霉素）对沙门氏菌分离株保持高活性。从这个地区的肺炎。在提交沙门氏菌分离株的大多数国家中，观察到对克拉霉素、阿奇霉素、复方新诺明和四环素的显著耐药率。pneumoniae的PROTEKT监测研究。总体而言，氟喹诺酮类耐药率较低（1%），尽管来自香港的70株分离株中有14.3%对左氧氟沙星和利福沙星耐药，但这些分离株中除1株外均属于23 F血清型的单一克隆。虽然目前显然仅限于克隆扩散的口袋，但仍需对氟喹诺酮类药物耐药性的演变保持警惕。泰利霉素（MIC 90 0.12 mg/L; 99.9%的敏感分离株）和利奈唑胺（MIC 90 2 mg/L; 100%的敏感分离株）是两种活性最高的口服药物，两种化合物均保留了对氟喹诺酮耐药链球菌分离株的活性。肺炎。1999-2000年PROTEKT监测研究的结果强调了沙门氏菌分离株对多种抗菌剂的耐药性的广泛演变。本研究证实了泰利霉素作为治疗由该微生物引起的社区获得性呼吸道感染的治疗选择的潜力。
The prevalence of resistance to a range of antimicrobials was determined for isolates of Streptococcus pneumoniae examined in the PROTEKT (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin) surveillance study (1999-2000) using NCCLS testing methods and interpretative criteria. Of 3362 pneumococcal isolates collected from 69 centres in 25 countries, 22.1% overall were resistant to penicillin G, with the highest rates of resistance found among isolates from Asia (53.4%), France (46.2%) and Spain (42.1%). Erythromycin A resistance occurred in 31.1% of isolates overall with the highest rates found in Asia (79.6%), France (57.6%), Hungary (55.6%) and Italy (42.9%). Marked geographical differences in the prevalence of both penicillin G (the Netherlands 0%; South Korea 71.5%) and erythromycin A (Sweden 4.7%; South Korea 87.6%) resistance were observed. Asia was characterized by the highest prevalence of resistance, overall, with only eight of 19 antimicrobials (co-amoxiclav, linezolid, vancomycin, teicoplanin, quinupristin/dalfopristin, levofloxacin, moxifloxacin and telithromycin) retaining high activity against isolates of S. pneumoniae from this region. Notable rates of resistance to clarithromycin, azithromycin, co-trimoxazole and tetracycline were observed in the majority of countries submitting isolates of S. pneumoniae to the PROTEKT surveillance study. Fluoroquinolone resistance was low (1%), overall, although 14.3% of 70 isolates from Hong Kong were resistant to levofloxacin and moxifloxacin, all but one of these isolates belonging to a single clone of the 23F serotype. Although, at present, apparently limited to pockets of clonal spread, continued vigilance with regard to the evolution of fluoroquinolone resistance is indicated. Telithromycin (MIC90 0.12 mg/L; 99.9% of isolates susceptible) and lin- ezolid (MIC90 2 mg/L; 100% of isolates susceptible) were the two most active oral agents tested, both compounds retaining activity against isolates of fluoroquinolone-resistant S. pneumoniae. The results of the PROTEKT surveillance study 1999-2000 emphasize the widespread evolution of resistance to a variety of antimicrobials amongst isolates of S. pneumoniae and demonstrate the potential of telithromycin as a therapeutic option for the treatment of community-acquired respiratory tract infections caused by this organism.