Affiliation:
1. Clinical Microbiology Institute, Wilsonville, Oregon
2. GR Micro Ltd., London, United Kingdom
Abstract
ABSTRACT
The PROTEKT US (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin in the United States) surveillance program was established to determine the prevalence and mechanisms of antibacterial resistance among bacterial pathogens from patients with community-acquired respiratory tract infections. In year 1 of the PROTEKT US study, 10,103 isolates of
Streptococcus pneumoniae
, including 3,133 erythromycin-resistant strains and 81 levofloxacin-resistant strains, were collected from 206 centers. We report on the molecular analyses of these resistant strains. The resistance genotypes among the 3,044 typed macrolide-resistant isolates overall were
mef
(A) (
n
= 2,157; 70.9%),
erm
(B) (
n
= 530; 17.4%),
mef
(A)
erm
(B) (
n
= 304; 10.0%), and
erm
(A) subclass
erm
(TR) (
n
= 5; 0.2%). Fifty (1.6%) macrolide-resistant isolates were negative for the
mef
and the
erm
resistance genes. Seventy-eight (96.3%) of the 81 levofloxacin-resistant isolates analyzed possessed multiple mutations in the
gyrA
,
gyrB
,
parC
, and/or
parE
quinolone resistance-determining regions. A total of 43 known multilocus sequence typing (MLST) profiles (or single- or double-locus variants) accounted for 75 of 81 isolates. There was no evidence of dissemination of fluoroquinolone-resistant clones within the United States; however, 12 isolates with the same MLST profile were located in one center in Massachusetts. Almost 90% of the erythromycin-resistant isolates and approximately one-third of the levofloxacin-resistant isolates were multidrug resistant.
Publisher
American Society for Microbiology
Cited by
34 articles.
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