title: Activity of telithromycin and seven other agents against 1034 pediatric Streptococcus pneumoniae isolates from ten central and eastern European centers.
abstract: OBJECTIVE
  To test the activity of telithromycin against 1034 Streptococcus pneumoniae isolates from pediatric patients in ten centers from ten central and eastern European countries during 2000-2001, and to compare it with the activities of erythromycin A, azithromycin, clarithromycin, clindamycin, and quinupristin-dalfopristin.
  
  
  METHODS
  The minimum inhibitory concentrations (MICs) of telithromycin, erythromycin A, azithromycin, clarithromycin, clindamycin, levofloxacin, quinupristin-dalfopristin and penicillin G were tested by the agar dilution method with incubation in air, and mechanisms of resistance to macrolides and quinolones were investigated.
  
  
  RESULTS
  Strains were isolated from sputum, tracheal aspirates, ear, eye, blood, and cerebrospinal fluid. Among S. pneumoniae strains tested, 36% had raised penicillin G MICs (>/= 0.12 mg/L). Susceptibilities were as follows: telithromycin, quinupristin-dalfopristin and levofloxacin, >/= 99%; clindamycin, 83%; and erythromycin A, azithromycin and clarithromycin, 78%. Of 230 (22.3%) erythromycin A-resistant S. pneumoniae strains, 176 (79.6%) had erm(B), 38 (16.1%) had mef(A), and 10 (4.3%) had mutations in 23S ribosomal RNA or in ribosomal protein L4. The rates of drug-resistant S. pneumoniae are high in all centers except Kaunas, Riga, and Prague.
  
  
  CONCLUSIONS
  Telithromycin had low MICs against all strains, irrespective of macrolide, azalide or clindamycin resistance. Ribosomal methylation was the most prevalent resistance mechanism among all resistant strains, except in Sofia, where the prevalence of the efflux mechanism was higher.
authors.affiliation: Department of Pathology, Hershey Medical Center, Hershey, Pennsylvania 17033, USA.
authors.forename: B
authors.initials: B
authors.lastname: Bozdogan
authors.forename: P C
authors.initials: PC
authors.lastname: Appelbaum
authors.forename: L M
authors.initials: LM
authors.lastname: Kelly
authors.forename: D B
authors.initials: DB
authors.lastname: Hoellman
authors.forename: A
authors.initials: A
authors.lastname: Tambic-Andrasevic
authors.forename: L
authors.initials: L
authors.lastname: Drukalska
authors.forename: W
authors.initials: W
authors.lastname: Hryniewicz
authors.forename: H
authors.initials: H
authors.lastname: Hupkova
authors.forename: M R
authors.initials: MR
authors.lastname: Jacobs
authors.forename: J
authors.initials: J
authors.lastname: Kolman
authors.forename: M
authors.initials: M
authors.lastname: Konkoly-Thege
authors.forename: J
authors.initials: J
authors.lastname: Miciuleviciene
authors.forename: M
authors.initials: M
authors.lastname: Pana
authors.forename: L
authors.initials: L
authors.lastname: Setchanova
authors.forename: J
authors.initials: J
authors.lastname: Trupl
authors.forename: P
authors.initials: P
authors.lastname: Urbaskova
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial / Q000502:physiology; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D048628:Ketolides; D018942:Macrolides; D013296:Streptococcus pneumoniae / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D048628:Ketolides; D018942:Macrolides; C106791:telithromycin