Antimicrobial resistance of Streptococcus pneumoniae and Haemophilus influenzae isolated from children with community-acquired respiratory tract infections in Central Poland
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.
Available from: Krzysztof Trzciński
- "Lack of susceptibility to tetracyclines was the common resistance phenotype in Streptococcus pneumoniae strains isolated in Poland, with a prevalence varying from 30% up to 50%, whereas an increase in resistance to penicillin and macrolides from less than 3% to 15% has been observed within the last decade    . The change in the profile of resistance was accompanied by the simultaneous emergence of the national epidemic clones Poland 23F -16 and Poland 6B - 20 and the introduction of international pandemic clones Spain 23F -1 and Spain 9V -3 to the country. "
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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.
Available from: Rudolf Lütticken
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ABSTRACT: In the present study, a real-time PCR protocol was developed for the detection of macrolide resistance determinants and was validated in a nationwide study in Germany covering a total of 236 Streptococcus pyogenes and 241 Streptococcus pneumoniae strains collected from children < or = 16 years of age with community-acquired infections. Macrolide resistance was observed in 19.9% of pneumococcal strains and 14% of S. pyogenes isolates. Of the erythromycin A-resistant S. pyogenes strains, 93.9% showed the efflux type mef(A); 62.5% of the S. pneumoniae strains were mef(A)- and 37.5% erm(B)-positive. The correlation of the results of real-time PCR assay genotyping in the present study compared with those of conventional PCR genotyping and resistance phenotyping was 100%. Macrolide resistance is of growing concern in Germany. This highly sensitive and specific PCR assay to detect macrolide resistance has the potential to provide sufficiently rapid results to improve antibiotic treatment of streptococcal infections.
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