Literature DB >> 14667791

Antibacterial resistance among children with community-acquired respiratory tract infections (PROTEKT 1999-2000).

D Felmingham1, D J Farrell, R R Reinert, I Morrissey.   

Abstract

OBJECTIVE: To determine the susceptibility of bacterial respiratory tract pathogens, isolated from children (0-12 years) as part of the global PROTEKT surveillance study (1999-2000), to a range of antibacterials, including the ketolide telithromycin.
METHODS: Minimum inhibitory concentrations of the antibacterials studied were determined at a central laboratory using the NCCLS microdilution broth method. Macrolide resistance mechanisms were detected by PCR.
RESULTS: Of 779 Streptococcus pneumoniae isolates worldwide, 43% were non-susceptible to penicillin (18% intermediate; 25% resistant) and 37% were resistant to erythromycin, with considerable intercountry variation. Eighteen per cent of 653 Haemophilus influenzae and >90% of 316 Moraxella catarrhalis isolates produced beta-lactamase. Of 640 Streptococcus pyogenes isolates, 10% were resistant to erythromycin, with considerable intercountry variation. All S. pneumoniae and 99.8% of H. influenzae isolates were susceptible to telithromycin using breakpoints proposed to the NCCLS (<or=1 and <or=4 mg/L, respectively). All M. catarrhalis and 97% of S. pyogenes and isolates were susceptible to <or=1 mg/L telithromycin.
CONCLUSIONS: Antibacterial resistance complicates the empirical treatment of respiratory tract infections in children and requires continued monitoring. Telithromycin may be a useful therapeutic alternative as it is highly active against strains exhibiting various resistance phenotypes.

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Year:  2004        PMID: 14667791     DOI: 10.1016/s0163-4453(03)00140-3

Source DB:  PubMed          Journal:  J Infect        ISSN: 0163-4453            Impact factor:   6.072


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