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Bacteriology

Prevalence and Molecular Analysis of Macrolide and Fluoroquinolone Resistance among Isolates of Streptococcus pneumoniae Collected during the 2000-2001 PROTEKT US Study

Steven D. Brown, David J. Farrell, Ian Morrissey
Steven D. Brown
1Clinical Microbiology Institute, Wilsonville, Oregon
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David J. Farrell
2GR Micro Ltd., London, United Kingdom
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Ian Morrissey
2GR Micro Ltd., London, United Kingdom
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  • For correspondence: I.morrissey@grmicro.co.uk
DOI: 10.1128/JCM.42.11.4980-4987.2004
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ABSTRACT

The PROTEKT US (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin in the United States) surveillance program was established to determine the prevalence and mechanisms of antibacterial resistance among bacterial pathogens from patients with community-acquired respiratory tract infections. In year 1 of the PROTEKT US study, 10,103 isolates of Streptococcus pneumoniae, including 3,133 erythromycin-resistant strains and 81 levofloxacin-resistant strains, were collected from 206 centers. We report on the molecular analyses of these resistant strains. The resistance genotypes among the 3,044 typed macrolide-resistant isolates overall were mef(A) (n = 2,157; 70.9%), erm(B) (n = 530; 17.4%), mef(A) erm(B) (n = 304; 10.0%), and erm(A) subclass erm(TR) (n = 5; 0.2%). Fifty (1.6%) macrolide-resistant isolates were negative for the mef and the erm resistance genes. Seventy-eight (96.3%) of the 81 levofloxacin-resistant isolates analyzed possessed multiple mutations in the gyrA, gyrB, parC, and/or parE quinolone resistance-determining regions. A total of 43 known multilocus sequence typing (MLST) profiles (or single- or double-locus variants) accounted for 75 of 81 isolates. There was no evidence of dissemination of fluoroquinolone-resistant clones within the United States; however, 12 isolates with the same MLST profile were located in one center in Massachusetts. Almost 90% of the erythromycin-resistant isolates and approximately one-third of the levofloxacin-resistant isolates were multidrug resistant.

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Prevalence and Molecular Analysis of Macrolide and Fluoroquinolone Resistance among Isolates of Streptococcus pneumoniae Collected during the 2000-2001 PROTEKT US Study
Steven D. Brown, David J. Farrell, Ian Morrissey
Journal of Clinical Microbiology Nov 2004, 42 (11) 4980-4987; DOI: 10.1128/JCM.42.11.4980-4987.2004

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Prevalence and Molecular Analysis of Macrolide and Fluoroquinolone Resistance among Isolates of Streptococcus pneumoniae Collected during the 2000-2001 PROTEKT US Study
Steven D. Brown, David J. Farrell, Ian Morrissey
Journal of Clinical Microbiology Nov 2004, 42 (11) 4980-4987; DOI: 10.1128/JCM.42.11.4980-4987.2004
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KEYWORDS

Anti-Bacterial Agents
community-acquired infections
Drug Resistance, Bacterial
Erythromycin
levofloxacin
Ofloxacin
respiratory tract infections
Streptococcus pneumoniae

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