title: Antibacterial resistance patterns in Streptococcus pneumoniae isolated from elderly patients: PROTEKT years 1-5 (1999-2004).
abstract: The antibacterial susceptibilities of 6,646 Streptococcus pneumoniae isolates collected in 38 countries from patients >or=65 years of age with community-acquired respiratory tract infections (RTIs) during years 1-5 of the PROTEKT study (1999-2004) were analysed. Rates of erythromycin resistance (36.0%), penicillin non-susceptibility (31.3%; 20.2% resistant plus 11.1% intermediately susceptible) and resistance to multiple antibacterials (37.2%) were stable over the 5 years. The most common macrolide resistance mechanism was erm(B) (61.4%); erm(B)+mef(A) strains increased from 5.4% (year 1) to 7.4% (year 5) (P=0.037). Overall, 37.2% of isolates exhibited resistance to two or more antibacterials, including 15.9% resistant to both penicillin and erythromycin. Antibacterial resistance was highest in the Far East. Telithromycin resistance was rare (0.12%). Appropriate alternative empirical first-line therapies may be required for treating community-acquired RTIs in the elderly.
authors.affiliation: Hospital Universitario Ramón y Cajal, Servicio de Microbiología, Carretera de Colmenar Km 9.1, 28034 Madrid, Spain. rcanton.hrc@salud.madrid.org
authors.forename: Rafael
authors.initials: R
authors.lastname: Cantón
authors.forename: Serhat
authors.initials: S
authors.lastname: Unal
authors.forename: David J
authors.initials: DJ
authors.lastname: Farrell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D004917:Erythromycin / Q000494:pharmacology; D006801:Humans; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000494:pharmacology; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D011159:Population Surveillance / Q000379:methods*; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D010406:Penicillins; D004917:Erythromycin