Waites Ken, Brown Steve
Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35233-7331, USA.
South Med J. 2003 Oct;96(10):974-85. doi: 10.1097/01.SMJ.0000091066.74656.6C.
PROTEKT US (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin in the United States) was established in 2000 to monitor antimicrobial resistance among respiratory tract pathogens across the United States.
During 2000 to 2001, 75 southern US centers collected 3,867 Streptococcus pneumoniae, 1,455 Streptococccus pyogenes and 1,042 Haemophilus influenzae.
Overall, 46.1% of S. pneumoniae isolates were nonsusceptible to penicillin, 35.8% were resistant to erythromycin, and 0.5% were resistant to fluoroquinolones. Against S. pneumoniae the most active agents were telithromycin (99.7% susceptible), linezolid (99.8%) and the fluoroquinolones (levofloxacin 99.4%, gatifloxacin 99.5%). The prevalence of erythromycin-resistant S. pyogenes isolates was 4.5%. Telithromycin, at concentration of < or = 1 mg/L, inhibited 99.9% of S. pyogenes. The prevalence of beta-lactamase positive H. influenzae was 26.2%. Telithromycin was active (MIC90 4 mg/L) against H. influenzae, irrespective of beta-lactamase production.
The prevalence of penicillin and macrolide resistance among respiratory tract pathogens from the southern United States is high. Fluoroquinolone resistance is low. Telithromycin is highly active against respiratory tract pathogens with reduced susceptibility to beta-lactams, macrolides, and fluoroquinolones.
美国PROTEKT研究（美国酮内酯类药物泰利霉素的前瞻性耐药菌追踪与流行病学研究）于2000年设立，旨在监测美国呼吸道病原体的抗菌药物耐药情况。
在2000年至2001年期间，美国南部的75个中心收集了3867株肺炎链球菌、1455株化脓性链球菌和1042株流感嗜血杆菌。
总体而言，46.1%的肺炎链球菌分离株对青霉素不敏感，35.8%对红霉素耐药，0.5%对氟喹诺酮类耐药。对于肺炎链球菌，活性最强的药物是泰利霉素（99.7%敏感）、利奈唑胺（99.8%）和氟喹诺酮类（左氧氟沙星99.4%，加替沙星99.5%）。化脓性链球菌分离株对红霉素的耐药率为4.5%。泰利霉素浓度≤1mg/L时，可抑制99.9%的化脓性链球菌。β-内酰胺酶阳性的流感嗜血杆菌患病率为26.2%。无论β-内酰胺酶产生情况如何，泰利霉素对流感嗜血杆菌均有活性（MIC90为4mg/L）。
美国南部呼吸道病原体中青霉素和大环内酯类耐药率较高。氟喹诺酮类耐药率较低。泰利霉素对β-内酰胺类、大环内酯类和氟喹诺酮类敏感性降低的呼吸道病原体具有高度活性。
