作为美国PROTEKT研究的一部分，于2001年至2002年从美国各地患者身上收集的肺炎链球菌、化脓性链球菌和流感嗜血杆菌的抗菌药敏情况。

Antimicrobial susceptibility of Streptococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae collected from patients across the USA, in 2001-2002, as part of the PROTEKT US study.

作者信息

Brown Steven D, Rybak Michael J

机构信息

Clinical Microbiology Institute, 9725 SW Commerce Circle, Suite A1, Wilsonville, OR 97070, USA.

出版信息

J Antimicrob Chemother. 2004 Aug;54 Suppl 1:i7-15. doi: 10.1093/jac/dkh313.

DOI:10.1093/jac/dkh313

PMID:15265831

Abstract

BACKGROUND

The PROTEKT US (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin in the United States) surveillance programme was started in 2000, to chart the emergence and spread of antimicrobial resistance among isolates of Streptococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae from across the USA.

METHODS

In 2001-2002 (Year 2 of PROTEKT US) 242 centres from 46 states and the territory of Puerto Rico submitted a total of 10 012 S. pneumoniae, 4508 S. pyogenes and 3296 H. influenzae isolates from community-acquired respiratory tract infections (CARTIs). Susceptibility testing was performed and interpreted using NCCLS methodology and criteria.

RESULTS

Overall, 35.4% of S. pneumoniae were non-susceptible to penicillin (14.2% intermediate, MIC 0.12-1 mg/L; 21.2% resistant, MIC > or =2 mg/L) and 27.9% were resistant to erythromycin (MIC > or =1 mg/L) (0.2% intermediate, MIC 0.5 mg/L). A total of 105 (1.0%) isolates were resistant to levofloxacin (MIC > or =8 mg/L). More than 99.2% of isolates were susceptible to telithromycin (MIC < or =1 mg/L) irrespective of penicillin and/or erythromycin resistance. All S. pyogenes isolates were susceptible to penicillin (MIC < or =0.12 mg/L) and 5.7% were resistant to erythromycin (MIC > or =1 mg/L) (0.3% intermediate, MIC 0.5 mg/L). The MIC90 of telithromycin for S. pyogenes was 0.03 mg/L. A total of 27.5% of H. influenzae isolates were beta-lactamase producers. Overall, 27.8% were resistant (MIC > or =4 mg/L) and 1.1% were intermediate to ampicillin (MIC 2 mg/L). A total of 96.3% of H. influenzae isolates were susceptible to telithromycin (MIC < or =4 mg/L).

CONCLUSIONS

Antimicrobial resistance continues to be a problem in the USA. The ketolide telithromycin continues to show high activity against common CARTI pathogens, including those resistant to beta-lactams and macrolides.

摘要

背景

美国PROTEKT（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）监测项目始于2000年，旨在绘制美国各地肺炎链球菌、化脓性链球菌和流感嗜血杆菌分离株中抗菌药物耐药性的出现和传播情况。

方法

在2001 - 2002年（PROTEKT美国项目的第2年），来自46个州和波多黎各地区的242个中心共提交了10012株社区获得性呼吸道感染（CARTIs）的肺炎链球菌、4508株化脓性链球菌和3296株流感嗜血杆菌分离株。采用美国国家临床实验室标准化委员会（NCCLS）的方法和标准进行药敏试验并解释结果。

结果

总体而言，35.4%的肺炎链球菌对青霉素不敏感（14.2%为中介，MIC 0.12 - 1mg/L；21.2%为耐药，MIC≥2mg/L），27.9%对红霉素耐药（MIC≥1mg/L）（0.2%为中介，MIC 0.5mg/L）。共有105株（1.0%）分离株对左氧氟沙星耐药（MIC≥8mg/L）。超过99.2%的分离株对泰利霉素敏感（MIC≤1mg/L），无论其对青霉素和/或红霉素是否耐药。所有化脓性链球菌分离株对青霉素敏感（MIC≤0.12mg/L），5.7%对红霉素耐药（MIC≥1mg/L）（0.3%为中介，MIC 0.5mg/L）。泰利霉素对化脓性链球菌的MIC90为0.03mg/L。共有27.5%的流感嗜血杆菌分离株产β-内酰胺酶。总体而言，27.8%对氨苄西林耐药（MIC≥4mg/L），1.1%为中介（MIC 2mg/L）。共有96.3%的流感嗜血杆菌分离株对泰利霉素敏感（MIC≤4mg/L）。