Telithromycin and quinupristin-dalfopristin resistance in clinical isolates of Streptococcus pyogenes: SMART program 2001 data

Po Ren Hsueh, Lee Jene Teng, Chun Ming Lee, Wen Kuei Huang, Tsu Lan 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

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Abstract

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 [MIC90], ≤0.03 μg/ml), cefotaxime (MIC90, ≤0.03 μg/ml), cefepime (MIC90, 0.06 μg/ml), meropenem (MIC90, ≤0.03 μg/ml), moxifloxacin (MIC90, 0.25 μg/ml), vancomycin (MIC90, 0.5 μg/ml), and linezolid (MIC90, 1 μg/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 ≥1 μg/ml, and all of these isolates exhibited erythromycin MICs of ≥32 μg/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.

Original languageEnglish
Pages (from-to)2152-2157
Number of pages6
JournalAntimicrobial Agents and Chemotherapy
Volume47
Issue number7
DOIs
Publication statusPublished - Jul 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Pharmacology (medical)

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    Hsueh, P. R., Teng, L. J., Lee, C. M., Huang, W. K., Wu, T. L., Wan, J. H., Yang, D., Shyr, J. M., Chuang, Y. C., Yan, J. J., Lu, J. J., Wu, J. J., Ko, W. C., Chang, F. Y., Yang, Y. C., Lau, Y. J., Liu, Y. C., Leu, H. S., Liu, C. Y., & Luh, K. T. (2003). Telithromycin and quinupristin-dalfopristin resistance in clinical isolates of Streptococcus pyogenes: SMART program 2001 data. Antimicrobial Agents and Chemotherapy, 47(7), 2152-2157. https://doi.org/10.1128/AAC.47.7.2152-2157.2003