Antibacterial resistance among children with community-acquired respiratory tract infections (PROTEKT 1999-2000)
Antibacterial resistance among children with community-acquired respiratory tract infections (PROTEKT 1999-2000)
复制标题
DOI：
10.1016/s0163-4453(03)00140-3
复制
发表时间：
2004-01-01
影响因子：
28.2
通讯作者：
Morrissey, I
中科院分区：
文献类型：
--
作者：
Felmingham, D;Farrell, DJ;Morrissey, I
Objective.确定作为全球PROTEKT监测研究（1999-2000）的一部分，从儿童（0-12岁）中分离的细菌性呼吸道病原体对一系列抗菌药物（包括酮内酯泰利霉素）的敏感性。在中心实验室使用NCCLS微量稀释肉汤法测定所研究抗菌剂的最低抑菌浓度。PCR检测耐药机制。在全世界779株肺炎链球菌分离株中，43%对青霉素不敏感（18%为中间型; 25%为耐药型），37%对红霉素耐药，国家间差异相当大。653株流感嗜血杆菌和316株卡他莫拉菌分离株中有18%和>90%产生β-内酰胺酶。在640株化脓性链球菌分离株中，10%对红霉素耐药，具有相当大的国家间差异。所有鼠伤寒沙门pneumoniae和H.使用NCCLS建议的折点（分别小于或等于1和小于或等于4 mg/L），流感病毒分离株对泰利霉素敏感。所有的M。卡他菌和97%的S.化脓菌和分离菌对≤ 1 mg/L的泰利霉素敏感。抗生素耐药性使儿童呼吸道感染的经验性治疗复杂化，需要持续监测。泰利霉素可能是一种有用的治疗替代品，因为它对表现出各种耐药表型的菌株具有高度活性。(C)2003年，英国传染病学会。由爱思唯尔有限公司出版。保留所有权利。
Objective. To determine the susceptibility of bacterial respiratory tract pathogens, isolated from children (0-12 years) as part of the global PROTEKT surveillance study (1999-2000), to a range of antibacterials, including the ketolide telithromycin.Methods. Minimum inhibitory concentrations of the antibacterials studied were determined at a central laboratory using the NCCLS microdilution broth method. Macrolide resistance mechanisms were detected by PCR.Results. Of 779 Streptococcus pneumoniae isolates worldwide, 43% were nonsusceptible to penicillin (18% intermediate; 25% resistant) and 37% were resistant to erythromycin, with considerable intercountry variation. Eighteen per cent of 653 Haemophilus influenzae and >90% of 316 Moraxella catarrhalis isolates produced beta-lactamase. Of 640 Streptococcus pyogenes isolates, 10% were resistant to erythromycin, with considerable intercountry variation. All S. pneumoniae and 99.8% of H. influenzae isolates were susceptible to telithromycin using breakpoints proposed to the NCCLS (less than or equal to1 and less than or equal to4 mg/L, respectively). All M. catarrhalis and 97% of S. pyogenes and isolates were susceptible to less than or equal to1 mg/L telithromycin.Conclusions. Antibacterial resistance complicates the empirical treatment of respiratory tract infections in children and requires continued monitoring. Telithromycin may be a useful therapeutic alternative as it is highly active against strains exhibiting various resistance phenotypes. (C) 2003 The British Infection Society. Published by Elsevier Ltd. All rights reserved.