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Braz J Infect Dis ; 7(1): 44-61, 2003 Feb.
Article in English | MEDLINE | ID: mdl-12807691

ABSTRACT

PROTEKT (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin) is a global surveillance study established in 1999 to monitor antibacterial resistance of respiratory tract organisms. Thirteen centers from Argentina, Brazil and Mexico participated during 1999-2000; they collected 1806 isolates (Streptococcus pneumoniae 518, Haemophilus influenzae 520, Moraxella catarrhalis 140, Staphylococcus aureus 351, S. pyogenes 277). Overall, 218 (42.1%) of the S. pneumoniae isolates had reduced susceptibility to penicillin, 79 (15.3%) were penicillin-resistant and 79 (15.3%) were erythromycin-resistant. Mexico had the highest prevalence of penicillin (76.5%) and erythromycin (31.2%) resistance. Of 77 erythromycin-resistant S. pneumoniae tested for resistance genotype, 43 possessed mef(A), 33 possessed erm(B) and 1 possessed both erm(B) and mef(A) mechanism. All S. pneumoniae isolates were fully susceptible to telithromycin, linezolid, teicoplanin and vancomycin. Among H. influenzae isolates, 88 (16.9%) produced beta-lactamase, ranging from 11% (Brazil) to 24.5% (Mexico). Among M. catarrhalis isolates, 138 (98.6%) produced beta-lactamase. Twenty-four (8.7%) of the S. pyogenes isolates were erythromycin-resistant; resistance being attributable to mefA (n=18), ermTR (n=5) and ermB (n=1). All H. influenzae, M. catarrhalis and S. pyogenes were fully susceptible to telithromycin. Methicillin resistance was found in 26.5% of the S. aureus isolates (Argentina 15%; Mexico 20%; Brazil 31.3%). Telithromycin was effective against 97.7% of methicillin-susceptible isolates. PROTEKT confirms that antibacterial resistance is an emerging problem in Latin America. The previously reported high levels of pneumococcal resistance to the beta-lactam and macrolides were exceeded. New agents that do not induce resistance or that exert low selective pressure, e.g. telithromycin, are essential to safeguard future antibacterial efficacy.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Erythromycin/therapeutic use , Penicillin Resistance , Respiratory Tract Infections/drug therapy , Anti-Bacterial Agents/pharmacology , Argentina/epidemiology , Brazil/epidemiology , Community-Acquired Infections/drug therapy , Community-Acquired Infections/epidemiology , Community-Acquired Infections/microbiology , Drug Resistance, Multiple , Erythromycin/pharmacology , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Haemophilus influenzae/drug effects , Haemophilus influenzae/isolation & purification , Humans , Mexico/epidemiology , Microbial Sensitivity Tests , Moraxella catarrhalis/drug effects , Moraxella catarrhalis/isolation & purification , Population Surveillance , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/microbiology , Staphylococcus aureus/drug effects , Staphylococcus aureus/isolation & purification , Streptococcus pneumoniae/drug effects , Streptococcus pneumoniae/isolation & purification , Streptococcus pyogenes/drug effects , Streptococcus pyogenes/isolation & purification
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