Antimicrobial susceptibility patterns of Streptococcus pneumoniae in Mexico (original) (raw)
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Antimicrobial agents and chemotherapy, 1999
A nationwide susceptibility surveillance of 1,113 Streptococcus pneumoniae isolates was carried out and found the following percentages of resistance: cefuroxime, 46%; penicillin, 37%; macrolides, 33%; aminopenicillins, 24%; cefotaxime, 13%; and ceftriaxone, 8%. A significant (P < 0.05) seasonality pattern for beta-lactam antibiotics was observed. Resistance to macrolides was higher (P < 0.05) in middle-ear samples. Higher percentages of resistance to cefuroxime and macrolides were observed among penicillin-intermediate and -resistant strains, whereas high frequencies of resistance to aminopenicillins and expanded-spectrum cephalosporins were observed only among penicillin-resistant strains.
Antimicrobial resistance among clinical isolates of Streptococcus pneumoniae in North America
The American Journal of Medicine, 1999
A total of 1,531 recent clinical isolates of Streptococcus pneumoniae were collected from 33 medical centers nationwide during the winter of 1999-2000 and characterized at a central laboratory. Of these isolates, 34.2% were penicillin nonsusceptible (MIC > 0.12 g/ml) and 21.5% were high-level resistant (MIC > 2 g/ml). MICs to all beta-lactam antimicrobials increased as penicillin MICs increased. Resistance rates among non-beta-lactam agents were the following: macrolides, 25.2 to 25.7%; clindamycin, 8.9%; tetracycline, 16.3%; chloramphenicol, 8.3%; and trimethoprim-sulfamethoxazole (TMP-SMX), 30.3%. Resistance to non-betalactam agents was higher among penicillin-resistant strains than penicillin-susceptible strains; 22.4% of S. pneumoniae were multiresistant. Resistance to vancomycin and quinupristin-dalfopristin was not detected. Resistance to rifampin was 0.1%. Testing of seven fluoroquinolones resulted in the following rank order of in vitro activity: gemifloxacin > sitafloxacin > moxifloxacin > gatifloxacin > levofloxacin ؍ ciprofloxacin > ofloxacin. For 1.4% of strains, ciprofloxacin MICs were >4 g/ml. The MIC 90 s (MICs at which 90% of isolates were inhibited) of two ketolides were 0.06 g/ml (ABT773) and 0.12 g/ml (telithromycin). The MIC 90 of linezolid was 2 g/ml. Overall, antimicrobial resistance was highest among middle ear fluid and sinus isolates of S. pneumoniae; lowest resistance rates were noted with isolates from cerebrospinal fluid and blood. Resistant isolates were most often recovered from children 0 to 5 years of age and from patients in the southeastern United States. This study represents a continuation of two previous national studies, one in 1994-1995 and the other in 1997-1998. Resistance rates with S. pneumoniae have increased markedly in the United States during the past 5 years. Increases in resistance from 1994-1995 to 1999-2000 for selected antimicrobial agents were as follows: penicillin, 10.6%; erythromycin, 16.1%; tetracycline, 9.0%; TMP-SMX, 9.1%; and chloramphenicol, 4.0%, the increase in multiresistance was 13.3%. Despite awareness and prevention efforts, antimicrobial resistance with S. pneumoniae continues to increase in the United States.
Antimicrobial Resistance among Clinical Isolates of Streptococcus pneumoniae in Canada during 2000
Antimicrobial Agents and Chemotherapy, 2002
A total of 2,245 clinical isolates of Streptococcus pneumoniae were collected from 63 microbiology laboratories from across Canada during 2000 and characterized at a central laboratory. Of these isolates, 12.4% were not susceptible to penicillin (penicillin MIC, >0.12 g/ml) and 5.8% were resistant (MIC, >2 g/ml). Resistance rates among non--lactam agents were the following: macrolides, 11.1%; clindamycin, 5.7%; chloramphenicol, 2.2%; levofloxacin, 0.9%; gatifloxacin, 0.8%; moxifloxacin, 0.4%; and trimethoprim-sulfamethoxazole, 11.3%. The MICs at which 90% of the isolates were inhibited (MIC 90 s) of the fluoroquinolones were the following: gemifloxacin, 0.03 g/ml; BMS-284756, 0.06 g/ml; moxifloxacin, 0.12 g/ml; gatifloxacin, 0.25 g/ml; levofloxacin, 1 g/ml; and ciprofloxacin, 1 g/ml. Of 578 isolates from the lower respiratory tract, 21 (3.6%) were inhibited at ciprofloxacin MICs of >4 g/ml. None of the 768 isolates from children were inhibited at ciprofloxacin MICs of >4 g/ml, compared to 3 of 731 (0.6%) from those ages 15 to 64 (all of these >60 years old), and 27 of 707 (3.8%) from those over 65. The MIC 90 s for ABT-773 and telithromycin were 0.015 g/ml for macrolide-susceptible isolates and 0.12 and 0.5 g/ml, respectively, for macrolide-resistant isolates. The MIC of linezolid was <2 g/ml for all isolates. Many of the new antimicrobial agents tested in this study appear to have potential for the treatment of multidrug-resistant strains of pneumococci.
Antimicrobial Agents and Chemotherapy, 1982
This study examined the resistance to penicillin, tetracycline, erythromycin, and chloramphenicol of 318 pneumococcal strains isolated in Spanish hospitals from blood or cerebrospinal fluid of patients during 1979 to 1981. The serotypes of these strains were determined to discover whether a correlation between serotype and patterns of antibiotic resistance could be found. Seven and nine patterns of resistance were found in strains isolated from blood and cerebrospinal fluid, respectively; tetracycline was the most frequent pattern, followed by tetracycline associated with chloramphenicol. A random distribution of serotypes which was similar to the general distribution of serotypes was found for resistance to tetracycline and chloramphenicol, but penicillin-resistant strains were confined to seven serotypes. Thirty-six strains of penicillin-resistant pneumococci isolated from sources other than blood or cerebrospinal fluid were also serotyped. They represented the same serotypes, sug...
Pneumonia Acquired in the Community Through Drug-Resistant Streptococcus pneumoniae
American Journal of Respiratory and Critical Care Medicine, 1999
The aim of the study was to determine the incidence of and risk factors for drug resistance of Streptococcus pneumoniae , and its impact on the outcome among hospitalized patients of pneumococcal pneumonia acquired in the community. Consecutive patients with culture-proven pneumococcal pneumonia were prospectively studied with regard to the incidence of pneumococcal drug resistance, potential risk factors, and in-hospital outcome variables. A total of 101 patients were studied. Drug resistance to penicillin, cephalosporin, or a macrolide drug was found in pneumococci from 52 of the 101 (52%) patients; 49% of these isolates were resistant to penicillin (16% intermediate resistance, 33% high resistance), 31% to cephalosporin (22% intermediate and 9% high resistance), and 27% to a macrolide drug. In immunocompetent patients, age Ͼ 65 yr was significantly associated with resistance to cephalosporin (odds ratio [OR]: 5.0; 95% confidence interval [CI]: 1.3 to 18.8, p ϭ 0.01), and with the presence of Ͼ 2 comorbidities with resistance to penicillin (OR: 4.7; 95% CI: 1.2 to 19.1; p Ͻ 0.05). In immunosuppressed patients, bacteremia was inversely associated with resistance to penicillin and cephalosporin (OR: 0.04; 95% CI: 0.003 to 0.45; p Ͻ 0.005; and OR: 0.46; 95% CI: 0.23 to 0.93; p Ͻ 0.05, respectively). Length of hospital stay, severity of pneumonia, and complications were not significantly affected by drug resistance. Mortality was 15% in patients with any drug resistance, as compared with 6% in those without resistance. However, any drug resistance was not significantly associated with death (relative risk [RR]: 2.5; 95% CI: 0.7 to 8.9; p ϭ 0.14). Moreover, attributable mortality in the presence of discordant antimicrobial treatment was 12%, as compared with 10% (RR: 1.2; 95% CI: 0.3 to 5.3; p ϭ 0.67) in the absence of such treatment. We conclude that the incidence of drug-resistant pneumococci was high. Risk factors for drug resistance included advanced age, comorbidity, and (inversely) bacteremia. Outcome was not significantly affected by drug resistance. Ewig S, Ruiz M, Torres A, Marco F, Martinez JA, Sanchez M, Mensa J. Pneumonia acquired in the community through drug-resistant Streptococcus pneumoniae .
Journal of Infection, 2005
The increasing prevalence of resistance to established antibiotics among key bacterial respiratory tract pathogens, such as Streptococcus pneumoniae, is a major healthcare problem in the USA. The PROTEKT US study is a longitudinal surveillance study designed to monitor the susceptibility of key respiratory tract pathogens in the USA to a range of commonly used antimicrobials. Here, we assess the geographic and temporal trends in antibacterial resistance of S. pneumoniae isolates from patients with community-acquired respiratory tract infections collected between Year 1 (2000Year 1 ( -2001 and Year 4 (2003Year 4 ( -2004 of PROTEKT US.
Annals of Clinical Microbiology and Antimicrobials, 2008
Background: The increasing prevalence of resistance to established antibiotics among key bacterial respiratory tract pathogens, such as Streptococcus pneumoniae, is a major healthcare problem in the USA. The PROTEKT US study is a longitudinal surveillance study designed to monitor the susceptibility of key respiratory tract pathogens in the USA to a range of commonly used antimicrobials. Here, we assess the geographic and temporal trends in antibacterial resistance of S. pneumoniae isolates from patients with community-acquired respiratory tract infections collected between Year 1 (2000-2001) and Year 4 (2003-2004) of PROTEKT US. Methods: Antibacterial minimum inhibitory concentrations were determined centrally using the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method; susceptibility was defined according to CLSI interpretive criteria. Macrolide resistance genotypes were determined by polymerase chain reaction. Results: A total of 39,495 S. pneumoniae isolates were collected during 2000-2004. The percentage of isolates resistant to erythromycin, penicillin, levofloxacin, and telithromycin were 29.3%, 21.2%, 0.9%, and 0.02%, respectively, over the 4 years, with marked regional variability. The proportion of isolates exhibiting multidrug resistance (includes isolates known as penicillin-resistant S. pneumoniae and isolates resistant to ≥ 2 of the following antibiotics: penicillin; second-generation cephalosporins, e.g. cefuroxime; macrolides; tetracyclines; and trimethoprim-sulfamethoxazole) remained stable at ~30% over the study period. Overall mef(A) was the most common macrolide resistance mechanism. The proportion of mef(A) isolates decreased from 68.8% to 62.3% between Year 1 and Year 4, while the percentage of isolates carrying both erm(B) and mef(A) increased from 9.7% to 18.4%. Over 99% of the erm(B)+mef(A)-positive isolates collected over Years 1-4 exhibited multidrug resistance. Higher than previously reported levels of macrolide resistance were found for mef(A)-positive isolates. Conclusion: Over the first 4 years of PROTEKT US, penicillin and erythromycin resistance among pneumococcal isolates has remained high. Although macrolide resistance rates have stabilized, the prevalence of clonal isolates, with a combined erm(B) and mef(A) genotype together with high-level macrolide and multidrug resistance, is increasing, and their spread may have serious health implications. Telithromycin and levofloxacin both showed potent in vitro activity against S. pneumoniae isolates irrespective of macrolide resistance genotype.
Drug‐Resistant Pneumococcal Pneumonia: Clinical Relevance and Related Factors
Clinical Infectious Diseases, 2004
A multicenter study of 638 cases of community-acquired pneumonia due to Streptococcus pneumoniae (SP-CAP) was performed to assess current levels of resistance. Of the pneumococcal strains, 35.7% had an minimum inhibitory concentration (MIC) of penicillin of у0.12 mg/mL (3 isolates had an MIC of 4 mg/mL), 23.8% had an MIC of erythromycin of 128 mg/mL, and 22.2% were multidrug resistant. Logistic regression determined that chronic pulmonary disease (odds ratio [OR], 1.44], human immunodeficiency virus infection (OR, 1.98), clinically suspected aspiration (OR, 2.12), and previous hospital admission (OR, 1.69) were related to decreased susceptibility to penicillin, and previous admission (OR, 1.89) and an MIC of penicillin of MIC у0.12 mg/mL (OR, 15.85) were related to erythromycin resistance (MIC, у1 mg/mL). The overall mortality rate was 14.4%. Disseminated intravascular coagulation, empyema, and bacteremia were significantly more frequent among patients with penicillin-susceptible SP-CAP. Among isolates with MICs of penicillin of у0.12 mg/mL, serotype 19 was predominant and was associated with a higher mortality rate. In summary, the rate of resistance to b-lactams and macrolides among S. pneumoniae that cause CAP remains high, but such resistance does not result in increased morbidity. The increasing incidence of multiple-antimicrobial resistance among Streptococcus pneumoniae isolates is be
S treptococcus pneumoniae remains a leading cause of morbidity and mortality worldwide, both in children and adults. Clinical manifestations of disease associated with this pathogen vary, and include meningitis, bacteremia, pneumonia and otitis media (1-6). Penicillin has been the drug of choice for treatment of pneumococcal infections, but penicillinnonsusceptible (NS; intermediate + resistant) isolates of S pneumoniae (PNSP) have been reported with increasing frequency from many parts of the world (7). Of even more concern is that PNSP are more likely than penicillin-susceptible strains to be NS to other classes of antimicrobials (7). The prevalence of resistance varies from country to country, and also within countries. PNSP rates are reportedly 28% in Europe and Latin America, 31% in Malaysia and 34% in the United States (8,9). Regional variation in pneumococcal antimicrobial susceptibility has been shown to occur in the United States, Europe and Canada (10-14). Data from Canadian sources over the past 30 years show that resistance of S pneumoniae to penicillin and other antimicrobials is increasing in this country. In the late 1970s, 2.4% of S pneumoniae isolates in Alberta and the Northwest Territories were penicillin NS (15). More than 25 years later, penicillin NS rates across Canada are 11.7% to 15%, with 3.3% to 6.5% of pneumococcal isolates being penicillin resistant (14,16,17). Surveillance data of S pneumoniae isolates submitted to participating laboratories in 2002 revealed penicillin originAl Article