title: Distribution and antibacterial susceptibility of macrolide resistance genotypes in Streptococcus pneumoniae: PROTEKT Year 5 (2003-2004).
abstract: The distribution and antibacterial susceptibility of macrolide resistance genotypes among 7083 Streptococcus pneumoniae isolates collected worldwide during 2003-2004 from patients with community-acquired respiratory tract infections, including patients within 48h of admission to hospital, were analysed. The overall rate of erythromycin resistance was 37.2% (intercountry range <10% to >50%). The most common resistance mechanism globally was erm(B) (55.0% of erythromycin-resistant S. pneumoniae (ERSP)), followed by mef(A) (30.6%) and erm(B)+mef(A) (12.0%). Genotype distribution varied by age group (P<0.0001); erm(B)+mef(A) was more prevalent (21.8% of isolates) among patients 0-2 years of age than among other age groups (P<0.001). The prevalence of tetracycline resistance among mef(A) isolates varied between different countries. Of the erm(B)+mef(A) strains, 43.5% were resistant to amoxicillin/clavulanic acid. Most ERSP isolates were susceptible to levofloxacin (98.3%) and telithromycin (99.4%).
authors.affiliation: G.R. Micro Ltd, 7-9 William Road, London NW1 3ER, UK. d.farrell@grmicro.co.uk
authors.forename: David J
authors.initials: DJ
authors.lastname: Farrell
authors.forename: Catherine
authors.initials: C
authors.lastname: Couturier
authors.forename: Waleria
authors.initials: W
authors.lastname: Hryniewicz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000382:microbiology; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018942:Macrolides / Q000494:pharmacology*; D008565:Membrane Proteins / Q000235:genetics; D008780:Methyltransferases / Q000235:genetics; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D013753:Tetracycline Resistance; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D018942:Macrolides; C117866:MefA protein, Streptococcus; D008565:Membrane Proteins; C111078:ErmTR protein, bacteria; D008780:Methyltransferases