Open AccessTelithromycin and Quinupristin-Dalfopristin Resistance in Clinical Isolates of Streptococcus pyogenes : SMART Program 2001 Data
Author(s) -
PoRen Hsueh,
LeeJene Teng,
Chun Ming Lee,
WeiChieh Huang,
TsungHan Wu,
Jen Hsien Wan,
Dine Yang,
Jainn Ming Shyr,
Yin Ching Chuang,
Jing Jou Yan,
Jang Jih Lu,
Jiunn Jong Wu,
Wen Chien Ko,
Feng Yee Chang,
Yi Chueh Yang,
Yeu Jun Lau,
Yung Ching Liu,
Hsieh-Shong Leu,
Cheng Yi Liu,
Kwen Tay Luh
Publication year - 2003
Publication title -
antimicrobial agents and chemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.07
H-Index - 259
eISSN - 1070-6283
pISSN - 0066-4804
DOI - 10.1128/aac.47.7.2152-2157.2003
Subject(s) - microbiology and biotechnology , telithromycin , moxifloxacin , quinupristin , biology , lincosamides , gatifloxacin , levofloxacin , dalfopristin , cefepime , agar dilution , antibacterial agent , penicillin , streptococcus pneumoniae , linezolid , minimum inhibitory concentration , erythromycin , antibiotic resistance , antimicrobial , imipenem , antibiotics , vancomycin , staphylococcus aureus , bacteria , genetics
This study evaluated the current status of antimicrobial resistance in clinical isolates of Streptococcus pyogenes in Taiwan as part of the SMART (Surveillance from Multicenter Antimicrobial Resistance in Taiwan) program. In 2001, 419 different isolates of S. pyogenes, including 275 from respiratory secretions, 87 from wound pus, and 31 from blood, were collected from nine hospitals in different parts of Taiwan. MICs of 23 antimicrobial agents were determined at a central location by the agar dilution method. All of the isolates were susceptible to penicillin (MIC at which 90% of the isolates were inhibited [MIC(90)], <or=0.03 microg/ml), cefotaxime (MIC(90), <or=0.03 microg/ml), cefepime (MIC(90), 0.06 microg/ml), meropenem (MIC(90), <or=0.03 microg/ml), moxifloxacin (MIC(90), 0.25 microg/ml), vancomycin (MIC(90), 0.5 microg/ml), and linezolid (MIC(90), 1 micro g/ml). Overall, 78% of isolates were not susceptible to erythromycin (54% were intermediate, and 24% were resistant), and 5% were not susceptible to clindamycin. Of the 101 erythromycin-resistant isolates, 80.2% exhibited the M phenotype (mefA gene positive), 18.9% exhibited the cMLS (constitutive resistance to macrolides-lincosamides-streptogramin B [MLS]) phenotype (ermB gene positive), and 1% exhibited the iMLS (inducible resistance to MLS) phenotype (ermB gene positive). Fluoroquinolones (sitafloxacin > moxifloxacin > ciprofloxacin = levofloxacin = gatifloxacin > gemifloxacin) demonstrated potent activity against nearly all of the isolates of S. pyogenes tested. Thirty-two isolates (8%) were not susceptible to quinupristin-dalfopristin. Seventeen percent of isolates had telithromycin MICs of >or=1 microg/ml, and all of these isolates exhibited erythromycin MICs of >or=32 microg/ml. The high prevalence of resistance to telithromycin (which is not available in Taiwan) limits its potential use in the treatment of S. pyogenes infections, particularly in areas with high rates of macrolide resistance.