Farrell David J, Couturier Catherine, Hryniewicz Waleria
G.R. Micro Ltd, 7-9 William Road, London NW1 3ER, UK.
Int J Antimicrob Agents. 2008 Mar;31(3):245-9. doi: 10.1016/j.ijantimicag.2007.10.022.
The distribution and antibacterial susceptibility of macrolide resistance genotypes among 7083 Streptococcus pneumoniae isolates collected worldwide during 2003-2004 from patients with community-acquired respiratory tract infections, including patients within 48h of admission to hospital, were analysed. The overall rate of erythromycin resistance was 37.2% (intercountry range <10% to >50%). The most common resistance mechanism globally was erm(B) (55.0% of erythromycin-resistant S. pneumoniae (ERSP)), followed by mef(A) (30.6%) and erm(B)+mef(A) (12.0%). Genotype distribution varied by age group (P<0.0001); erm(B)+mef(A) was more prevalent (21.8% of isolates) among patients 0-2 years of age than among other age groups (P<0.001). The prevalence of tetracycline resistance among mef(A) isolates varied between different countries. Of the erm(B)+mef(A) strains, 43.5% were resistant to amoxicillin/clavulanic acid. Most ERSP isolates were susceptible to levofloxacin (98.3%) and telithromycin (99.4%).
对2003 - 2004年期间从社区获得性呼吸道感染患者（包括入院48小时内的患者）中收集的7083株肺炎链球菌分离株，分析了大环内酯类耐药基因型的分布及抗菌药敏情况。红霉素耐药的总体发生率为37.2%（国家间范围为<10%至>50%）。全球最常见的耐药机制是erm(B)（占红霉素耐药肺炎链球菌（ERSP）的55.0%），其次是mef(A)（30.6%）和erm(B)+mef(A)（12.0%）。基因型分布因年龄组而异（P<0.0001）；erm(B)+mef(A)在0 - 2岁患者中比在其他年龄组中更普遍（占分离株的21.8%）（P<0.001）。不同国家间，mef(A)分离株中四环素耐药的发生率有所不同。在erm(B)+mef(A)菌株中，43.5%对阿莫西林/克拉维酸耐药。大多数ERSP分离株对左氧氟沙星（98.3%）和泰利霉素（99.4%）敏感。
