Activity of telithromycin and seven other agents against 1034 pediatric Streptococcus pneumoniae isolates from ten central and eastern European centers

To test the activity of telithromycin against 1034 Streptococcus pneumoniae isolates from pediatric patients in ten centers from ten central and eastern European countries during 2000–2001, and to compare it with the activities of erythromycin A, azithromycin, clarithromycin, clindamycin, and quinup...

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Published in:Clinical microbiology and infection 2003-07, Vol.9 (7), p.653-661
Main Authors: Bozdogan, B., Appelbaum, P.C., Kelly, L.M., Hoellman, D.B., Tambic-Andrasevic, A., Drukalska, L., Hryniewicz, W., Hupkova, H., Jacobs, M.R., Kolman, J., Konkoly-Thege, M., Miciuleviciene, J., Pana, M., Setchanova, L., Trupl, J., Urbaskova, P.
Format: Article
Language:English
Subjects:
Adolescent
Anti-Bacterial Agents - pharmacology
Bacterial diseases
Biological and medical sciences
Central Europe
Child
Child, Preschool
drug resistance
Drug Resistance, Bacterial - physiology
Eastern Europe
Electrophoresis, Gel, Pulsed-Field
Human bacterial diseases
Humans
Infant
Infant, Newborn
Infectious diseases
Ketolides
Macrolides
Medical sciences
Staphylococcal infections, streptococcal infections, pneumococcal infections
Streptococcus pneumoniae
Streptococcus pneumoniae - drug effects
telithromycin
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Summary:To test the activity of telithromycin against 1034 Streptococcus pneumoniae isolates from pediatric patients in ten centers from ten central and eastern European countries during 2000–2001, and to compare it with the activities of erythromycin A, azithromycin, clarithromycin, clindamycin, and quinupristin–dalfopristin. The minimum inhibitory concentrations (MICs) of telithromycin, erythromycin A, azithromycin, clarithromycin, clindamycin, levofloxacin, quinupristin–dalfopristin and penicillin G were tested by the agar dilution method with incubation in air, and mechanisms of resistance to macrolides and quinolones were investigated. Strains were isolated from sputum, tracheal aspirates, ear, eye, blood, and cerebrospinal fluid. Among S. pneumoniae strains tested, 36% had raised penicillin G MICs (≥0.12 mg/L). Susceptibilities were as follows: telithromycin, quinupristin–dalfopristin and levofloxacin, ≥ 99%; clindamycin, 83%; and erythromycin A, azithromycin and clarithromycin, 78%. Of 230 (22.3%) erythromycin A-resistant S. pneumoniae strains, 176 (79.6%) had erm(B), 38 (16.1%) had mef(A), and 10 (4.3%) had mutations in 23S ribosomal RNA or in ribosomal protein L4. The rates of drug-resistant S. pneumoniae are high in all centers except Kaunas, Riga, and Prague. Telithromycin had low MICs against all strains, irrespective of macrolide, azalide or clindamycin resistance. Ribosomal methylation was the most prevalent resistance mechanism among all resistant strains, except in Sofia, where the prevalence of the efflux mechanism was higher.
ISSN:1198-743X
1469-0691
DOI:10.1046/j.1469-0691.2003.00597.x