Antimicrobial resistance of Streptococcus pneumoniae and Haemophilus influenzae isolated from children with community-acquired respiratory tract infections in Central Poland
ABSTRACT Resistance to commonly used antimicrobial agents among the key respiratory pathogens is increasing worldwide and therefore a rational choice of an empirical treatment requires knowledge of both global and local resistance patterns. The susceptibility of 185 Streptococcus pneumoniae and 169 Haemophilus influenzae isolates collected from January 1999 to May 2002 at the Children's Memorial Health Institute, Warsaw, Poland, from 351 children with community-acquired respiratory tract infections (RTIs) has been determined. Of S. pneumoniae isolates, 84% were susceptible to penicillin, 91% to cefaclor, 95% to cefuroxime, 98% to cefotaxime, 79% to erythromycin, 46% to co-trimoxazole, 82% to clindamycin and 59% to tetracycline. The majority (83%) of erythromycin-resistant isolates tested carried the erm(B) gene, conferring the MLS(B) phenotype. All tetracycline-resistant S. pneumoniae strains analysed were tet(M) positive and tet(O) negative. A total of 24% of H. influenzae isolates were beta-lactamase-positive. H. influenzae susceptibility to amoxicillin/clavulanate, cefaclor, cefuroxime, azithromycin, tetracycline and co-trimoxazole was 100, 89, 94, 96, 96 and 43%, respectively.
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ABSTRACT: A collection of 185 Streptococcus pneumoniae isolates was tested for their susceptibility to antipneumococcal drugs, with a focus on the distribution of tetracycline resistance determinants tet(M) and tet(O). Resistance patterns were compared with established correlates of multidrug resistance, and tetracycline-resistant isolates were tested for clonality and allelic variation within tet(M). Resistance to tetracyclines, penicillins and macrolides were all strongly related to multidrug resistance. Over one-quarter of the strains were tetracycline resistant, all via the tet(M)-mediated mechanism. Restriction fragment length polymorphism analysis revealed a high degree of allelic variation within tet(M) and gave evidence of a clonal and horizontal spread of selected alleles. A tet(M) variant that emerged with the onset of epidemic multidrug-resistant strains was replacing old alleles in the population.International Journal of Antimicrobial Agents 03/2006; 27(2):159-64. DOI:10.1016/j.ijantimicag.2005.10.003 · 4.26 Impact Factor
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ABSTRACT: The resistance of Helicobacter pylori to antimicrobials, known to be increasing in many countries, is an important factor compromising the efficacy of eradication therapy. Therefore, our study aimed at analysing the current susceptibility status of H. pylori in Poland. A total of 337 H. pylori isolates were cultured from children (N=179) and adults (N=158) from various regions of the country from January 2001 to December 2004. All strains were susceptible to amoxicillin and tetracycline. The overall resistance to clarithromycin (CL) was 28%, but there were significant differences between the centres (ranging from 0% to 33%) and between child and adult isolates (28% versus 15%, respectively; P=0.01) for primary a resistance. Altogether, 46% of H. pylori isolates were resistant to metronidazole (MTZ) and 20% of isolates were simultaneously resistant to CL and MTZ.International Journal of Antimicrobial Agents 10/2005; 26(3):230-4. DOI:10.1016/j.ijantimicag.2005.06.015 · 4.26 Impact Factor
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ABSTRACT: New data on antibiotic susceptibility of common respiratory pathogens in Poland create an opportunity to modify the current guidelines for antibiotic therapy known as “Rekomendacje 2003”. The new guidelines should be prepared according to recent principles of preparation and presentation of diagnostic and therapeutic guidelines. In viral infections, i.e. the common cold, acute bronchitis, and bronchiolitis, principles of carefull care and symptomatic treatment such as analgesia and antypyrexia should be prepared and presented. In streptococcal tonsillitis shorter alternatives to 10-day penicillin therapy with amoxicillin or cephalosporins should be offered. In acute otitis media and acute rhinosinusis, which are initially viral nasopharyngeal infections with overimposed bacterial superinfections, the duration of the “watchfull waiting” strategy should be precisely defined. The increasing antibiotic resistance of Streptococcus pneumoniae requires increasing the single doses of betalactam antibiotics and of the daily dose to overcome resistance and simultaneously allows decreasing the frequency of antibiotic administration and shortening the duration of therapy. The increase in the percentage of betalactamase-producing Haemophilus influenzae requires administration of amoxicillin + clavulanate in a new proportion of 14:1–16:1. resulting from the high dose of amoxicillin. The principles of antibiotic substitution in case of allergy to betalactams should be modified. In non-immediate allergy for penicillins cephalosporins may be an alternative. In the case of immediate allergy to any betalactam or nonimmediate allergy to all betalactams, macrolides are an appriopriate subsitute.Pediatria polska 04/2007; 82(4):269-283. DOI:10.1016/S0031-3939(07)70400-6