title: Antimicrobial susceptibility of Streptococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae collected from patients across the USA, in 2001-2002, as part of the PROTEKT US study.
abstract: BACKGROUND
  The PROTEKT US (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin in the United States) surveillance programme was started in 2000, to chart the emergence and spread of antimicrobial resistance among isolates of Streptococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae from across the USA.
  
  
  METHODS
  In 2001-2002 (Year 2 of PROTEKT US) 242 centres from 46 states and the territory of Puerto Rico submitted a total of 10 012 S. pneumoniae, 4508 S. pyogenes and 3296 H. influenzae isolates from community-acquired respiratory tract infections (CARTIs). Susceptibility testing was performed and interpreted using NCCLS methodology and criteria.
  
  
  RESULTS
  Overall, 35.4% of S. pneumoniae were non-susceptible to penicillin (14.2% intermediate, MIC 0.12-1 mg/L; 21.2% resistant, MIC > or =2 mg/L) and 27.9% were resistant to erythromycin (MIC > or =1 mg/L) (0.2% intermediate, MIC 0.5 mg/L). A total of 105 (1.0%) isolates were resistant to levofloxacin (MIC > or =8 mg/L). More than 99.2% of isolates were susceptible to telithromycin (MIC < or =1 mg/L) irrespective of penicillin and/or erythromycin resistance. All S. pyogenes isolates were susceptible to penicillin (MIC < or =0.12 mg/L) and 5.7% were resistant to erythromycin (MIC > or =1 mg/L) (0.3% intermediate, MIC 0.5 mg/L). The MIC90 of telithromycin for S. pyogenes was 0.03 mg/L. A total of 27.5% of H. influenzae isolates were beta-lactamase producers. Overall, 27.8% were resistant (MIC > or =4 mg/L) and 1.1% were intermediate to ampicillin (MIC 2 mg/L). A total of 96.3% of H. influenzae isolates were susceptible to telithromycin (MIC < or =4 mg/L).
  
  
  CONCLUSIONS
  Antimicrobial resistance continues to be a problem in the USA. The ketolide telithromycin continues to show high activity against common CARTI pathogens, including those resistant to beta-lactams and macrolides.
authors.affiliation: Clinical Microbiology Institute, 9725 SW Commerce Circle, Suite A1, Wilsonville, OR 97070, USA. SBrown@clinmicroinst.com
authors.forename: Steven D
authors.initials: SD
authors.lastname: Brown
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rybak
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D006193:Haemophilus influenzae / Q000187:drug effects*; D006801:Humans; D008137:Longitudinal Studies; D018942:Macrolides / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D011159:Population Surveillance; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D013297:Streptococcus pyogenes / Q000187:drug effects*; D014481:United States / Q000453:epidemiology
chemical_list: D000890:Anti-Infective Agents; D018942:Macrolides