title: Resistance patterns of selected respiratory tract pathogens in Poland.
abstract: This study presents the results of a survey of the in-vitro susceptibility to antimicrobial agents of major pathogens responsible for community-acquired respiratory tract infections in Poland during 2002-2004. The collection of 1184 bacterial isolates comprised 398 Streptococcus pneumoniae, 344 Haemophilus influenzae, 302 Streptococcus pyogenes and 140 Moraxella catarrhalis. Among the pneumococcal isolates, 16.8% were penicillin-non-susceptible (PNSP), of which 80.6% were identified as multidrug-resistant. Overall, 9.0% of H. influenzae isolates were beta-lactamase-positive, although this percentage increased noticeably in the third year of the study. Based on PCR results, 12.8% of H. influenzae isolates were identified as low-level beta-lactamase-negative, ampicillin-resistant (BLNAR), and one isolate as low-level beta-lactamase-positive, amoxycillin-clavulanic acid-resistant (BLPACR). Pulsed-field gel electrophoresis (PFGE) classified 45 H. influenzae isolates with altered penicillin-binding proteins into 15 PFGE types, including two predominant types (with four and six sub-types) containing 15 and ten isolates, respectively. Resistance to tetracycline, erythromycin and clindamycin was found in 20.9%, 8.9% and 4.6% of S. pyogenes isolates, respectively. The production of beta-lactamase characterised 91.4% of M. catarrhalis isolates. In summary, the overall occurrence of PNSP in Poland remains stable, although there was a noticeable increase in the proportion of fully-resistant isolates. A rising trend in the prevalence of beta-lactamase producers and low-level BLNAR isolates was observed among Polish isolates of H. influenzae.
authors.affiliation: Department of Epidemiology and Clinical Microbiology, National Institute of Public Health, Warsaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Skoczyńska
authors.forename: M
authors.initials: M
authors.lastname: Kadłubowski
authors.forename: I
authors.initials: I
authors.lastname: Waśko
authors.forename: J
authors.initials: J
authors.lastname: Fiett
authors.forename: W
authors.initials: W
authors.lastname: Hryniewicz
mesh_terms: D004352:Drug Resistance, Microbial; D016521:Electrophoresis, Gel, Pulsed-Field; D006193:Haemophilus influenzae / Q000187:drug effects*; D006801:Humans; D008826:Microbial Sensitivity Tests; D001936:Moraxella catarrhalis / Q000187:drug effects*; D010403:Penicillin Resistance; D012141:Respiratory Tract Infections / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D013297:Streptococcus pyogenes / Q000187:drug effects*; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D001618:beta-Lactamases