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Journal of Clinical Microbiology, February 2007, p. 290-293, Vol. 45, No. 2
0095-1137/07/$08.00+0     doi:10.1128/JCM.01653-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Prevalence and Antibacterial Susceptibility of mef(A)-Positive Macrolide-Resistant Streptococcus pneumoniae over 4 Years (2000 to 2004) of the PROTEKT US Study

G. R. Micro, Ltd., London, United Kingdom,¹ Summa Health System, Akron, Ohio,² Mount Sinai School of Medicine, New York, New York³

Received 10 August 2006/ Returned for modification 19 September 2006/ Accepted 31 October 2006

In the United States, approximately 30% of Streptococcus pneumoniae isolates are macrolide (erythromycin [ERY]) resistant (ERSP), most commonly due to expression of the mef(A) gene previously associated with lower-level ERY resistance (ERY^r; MIC = 1 to 4 µg/ml). The data from the PROTEKT US surveillance study were analyzed to evaluate the prevalence and antibacterial susceptibility of mef(A)-positive ERSP. In all, 26,634 isolates of S. pneumoniae were collected in the United States between 2000 and 2004 from centers common to all years. ERY^r was stable at approximately 29% over the 4 years, but the proportion of ERSP isolates positive for mef(A) alone decreased (year 1 [2000 to 2001], 69.0%; year 4 [2003 to 2004], 60.7%), with the sharpest declines seen in isolates from patients from 0 to 2 years of age. Conversely, the proportion isolates positive for both erm(B) and mef(A) increased over the duration of the present study (year 1, 9.3%; year 4, 19.1%), a change that was again most marked in patients aged 2 years. The majority of ERSP isolates expressing mef(A) alone exhibited higher than previously reported levels of ERY^r (MIC₉₀ = 16 µg/ml). However, the ketolide antibacterial telithromycin consistently demonstrated in vitro activity against these isolates over the 4 years of the study (MIC₉₀ = 0.5 to 1 µg/ml).

Published ahead of print on 8 November 2006.

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