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Emergence of multidrug-resistant Streptococcus pneumoniae: report from the SENTRY Antimicrobial Surveillance Program (1999-2003).
Diagn Microbiol Infect Dis. 2006 Sep; 56(1):69-74.DM

Abstract

Emerging resistance among Streptococcus pneumoniae to penicillin, erythromycin, clindamycin, tetracyclines, and trimethoprim-sulfamethoxazole continues to compromise orally administered therapy for community-acquired respiratory tract infections. Concern also exists that multidrug-resistant (MDR) S. pneumoniae and Haemophilus influenzae strains could develop fluoroquinolone resistance (FQR). S. pneumoniae (2379 strains), H. influenzae (2456), and Moraxella catarrhalis (901) studied as part of the SENTRY Antimicrobial Surveillance Program in 2003 were tested by reference MIC methods against 16 antimicrobials. In addition, 592 strains of S. pneumoniae from 1999 to 2003 were assessed for trends in MDR occurrences. H. influenzae beta-lactamase production varied from 11.6% in Latin America to 27.3% in North America, whereas beta-lactamase rates for M. catarrhalis remained stable at 94.7-95.6%. Penicillin resistance (MIC, > or =2 microg/mL) in S. pneumoniae was 14.7%, 12.7%, and 15.9% for Europe, Latin America, and North America, respectively. MDR S. pneumoniae increased from 5.7% (1999) to 6.3% (2003) in North America, but no FQR increase to new agents (gatifloxacin) was detected in the 2001-2003 MDR S. pneumoniae isolates. Five epidemic clusters of FQR S. pneumoniae (levofloxacin MIC, >32 microg/mL) strains have been reported by our group previously in Italian medical centers in 2002-2004. Unlike the strains described here, those strains were susceptible to beta-lactams, trimethoprim-sulfamethoxazole, chloramphenicol, and rifampin, and resistant to macrolide-lincosamide-streptogramin B agents and tetracycline (not meeting MDR criteria). Excluding these clones from Italy, overall FQR rates did not significantly vary from the prior years' experience across the regions (North America > Europe > Latin America). In conclusion, MDR and FQR S. pneumoniae continue to occur across all geographic regions monitored with some detectable clonality. The monitoring of emerging resistance as part of surveillance programs is useful in differentiating sporadic from clonal resistances, an important distinction when assessing prospective public health interventions or empiric therapy recommendations.

Authors+Show Affiliations

JMI Laboratories, North Liberty, IA 52317, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16546341

Citation

Johnson, David M., et al. "Emergence of Multidrug-resistant Streptococcus Pneumoniae: Report From the SENTRY Antimicrobial Surveillance Program (1999-2003)." Diagnostic Microbiology and Infectious Disease, vol. 56, no. 1, 2006, pp. 69-74.
Johnson DM, Stilwell MG, Fritsche TR, et al. Emergence of multidrug-resistant Streptococcus pneumoniae: report from the SENTRY Antimicrobial Surveillance Program (1999-2003). Diagn Microbiol Infect Dis. 2006;56(1):69-74.
Johnson, D. M., Stilwell, M. G., Fritsche, T. R., & Jones, R. N. (2006). Emergence of multidrug-resistant Streptococcus pneumoniae: report from the SENTRY Antimicrobial Surveillance Program (1999-2003). Diagnostic Microbiology and Infectious Disease, 56(1), 69-74.
Johnson DM, et al. Emergence of Multidrug-resistant Streptococcus Pneumoniae: Report From the SENTRY Antimicrobial Surveillance Program (1999-2003). Diagn Microbiol Infect Dis. 2006;56(1):69-74. PubMed PMID: 16546341.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergence of multidrug-resistant Streptococcus pneumoniae: report from the SENTRY Antimicrobial Surveillance Program (1999-2003). AU - Johnson,David M, AU - Stilwell,Matthew G, AU - Fritsche,Thomas R, AU - Jones,Ronald N, Y1 - 2006/03/20/ PY - 2005/11/08/received PY - 2005/12/13/accepted PY - 2006/3/21/pubmed PY - 2006/10/25/medline PY - 2006/3/21/entrez SP - 69 EP - 74 JF - Diagnostic microbiology and infectious disease JO - Diagn Microbiol Infect Dis VL - 56 IS - 1 N2 - Emerging resistance among Streptococcus pneumoniae to penicillin, erythromycin, clindamycin, tetracyclines, and trimethoprim-sulfamethoxazole continues to compromise orally administered therapy for community-acquired respiratory tract infections. Concern also exists that multidrug-resistant (MDR) S. pneumoniae and Haemophilus influenzae strains could develop fluoroquinolone resistance (FQR). S. pneumoniae (2379 strains), H. influenzae (2456), and Moraxella catarrhalis (901) studied as part of the SENTRY Antimicrobial Surveillance Program in 2003 were tested by reference MIC methods against 16 antimicrobials. In addition, 592 strains of S. pneumoniae from 1999 to 2003 were assessed for trends in MDR occurrences. H. influenzae beta-lactamase production varied from 11.6% in Latin America to 27.3% in North America, whereas beta-lactamase rates for M. catarrhalis remained stable at 94.7-95.6%. Penicillin resistance (MIC, > or =2 microg/mL) in S. pneumoniae was 14.7%, 12.7%, and 15.9% for Europe, Latin America, and North America, respectively. MDR S. pneumoniae increased from 5.7% (1999) to 6.3% (2003) in North America, but no FQR increase to new agents (gatifloxacin) was detected in the 2001-2003 MDR S. pneumoniae isolates. Five epidemic clusters of FQR S. pneumoniae (levofloxacin MIC, >32 microg/mL) strains have been reported by our group previously in Italian medical centers in 2002-2004. Unlike the strains described here, those strains were susceptible to beta-lactams, trimethoprim-sulfamethoxazole, chloramphenicol, and rifampin, and resistant to macrolide-lincosamide-streptogramin B agents and tetracycline (not meeting MDR criteria). Excluding these clones from Italy, overall FQR rates did not significantly vary from the prior years' experience across the regions (North America > Europe > Latin America). In conclusion, MDR and FQR S. pneumoniae continue to occur across all geographic regions monitored with some detectable clonality. The monitoring of emerging resistance as part of surveillance programs is useful in differentiating sporadic from clonal resistances, an important distinction when assessing prospective public health interventions or empiric therapy recommendations. SN - 0732-8893 UR - https://www.unboundmedicine.com/medline/citation/16546341/Emergence_of_multidrug_resistant_Streptococcus_pneumoniae:_report_from_the_SENTRY_Antimicrobial_Surveillance_Program__1999_2003__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0732-8893(05)00357-3 DB - PRIME DP - Unbound Medicine ER -