title: Increasing prevalence of multidrug-resistant Streptococcus pneumoniae in the United States over a 10-year period: Alexander Project.
abstract: The Alexander Project is a global surveillance study conducted from 1992 to 2001. Minimum inhibitory concentrations and percent resistance to a panel of antimicrobial agents were determined according to National Committee for Clinical Laboratory Standards methodology. Resistance to penicillin (PEN-R) and erythromycin (ERY-R) have increased in the period 1992-2001 by 3.9 and 4.5 times to 20.7% and 27.9%, respectively. Joint PEN-ERY-R has increased 4.9 times, up to 15.3%. In 1992, 57.1% of all PEN-R isolates were also ERY-R, whereas in 2001, 75.8% were ERY-R. Resistance to only 1 antibiotic increased slightly, from 8% in 1992 to 12% in 2001, whereas resistance to more than 1 antibiotic increased 4.3 times, from 6.4% in 1992 to 27.8% of all strains in 2001. Multidrug-resistant pneumococci are an increasingly common finding in the United States. Three of four PEN-R isolates are also multiresistant. The rate of growth of multidrug resistance is higher than that of single antibiotic resistance.
authors.affiliation: GlaxoSmithKline, Biomedical Data Sciences, Research Triangle Park, NC 27709-3398, USA. robertino.mera@gsk.com
authors.forename: Robertino M
authors.initials: RM
authors.lastname: Mera
authors.forename: Linda A
authors.initials: LA
authors.lastname: Miller
authors.forename: Justin J D
authors.initials: JJ
authors.lastname: Daniels
authors.forename: John G
authors.initials: JG
authors.lastname: Weil
authors.forename: Anthony R
authors.initials: AR
authors.lastname: White
mesh_terms: D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D015995:Prevalence; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D013997:Time Factors; D014481:United States / Q000453:epidemiology