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Distribution and antibacterial susceptibility of macrolide resistance genotypes in Streptococcus pneumoniae: PROTEKT

David J Farrell1, Catherine Couturier, Waleria Hryniewicz

  • 1G.R. Micro Ltd, 7-9 William Road, London NW1 3ER, UK. d.farrell@grmicro.co.uk

International Journal of Antimicrobial Agents
|January 8, 2008
PubMed

Insights

Macrolide resistance in Streptococcus pneumoniae is common, with erm(B) being the most frequent mechanism. Resistance patterns varied by age, with dual erm(B)+mef(A) genotypes prevalent in young children.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Streptococcus pneumoniae causes community-acquired respiratory tract infections globally.
  • Macrolide resistance is a growing concern in S. pneumoniae infections.
  • Understanding resistance genotypes is crucial for effective treatment strategies.

Purpose of the Study:

  • To analyze the distribution and antimicrobial susceptibility of macrolide resistance genotypes in S. pneumoniae.
  • To investigate variations in genotype prevalence across different age groups and geographical regions.
  • To assess the susceptibility of resistant strains to other antibiotics.

Main Methods:

  • Analysis of 7083 S. pneumoniae isolates collected worldwide (2003-2004).
  • Identification of macrolide resistance genotypes (erm(B), mef(A), erm(B)+mef(A)).
  • Determination of antibacterial susceptibility profiles for various antibiotics.

Main Results:

  • Overall erythromycin resistance rate was 37.2%.
  • The predominant resistance mechanisms were erm(B) (55.0%), mef(A) (30.6%), and combined erm(B)+mef(A) (12.0%).
  • The erm(B)+mef(A) genotype was significantly more common in children aged 0-2 years (21.8%).
  • High susceptibility rates were observed for levofloxacin (98.3%) and telithromycin (99.4%) among erythromycin-resistant isolates.

Conclusions:

  • Macrolide resistance in S. pneumoniae is widespread, with specific genotypes dominating globally.
  • Age-specific variations in resistance genotype distribution highlight the need for tailored treatment approaches.
  • Newer antibiotics like levofloxacin and telithromycin remain effective against most resistant S. pneumoniae strains.

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