TY - JOUR
T1 - The Alexander project 1998-2000
T2 - Susceptibility of pathogens isolated from community-acquired respiratory tract infection to commonly used antimicrobial agents
AU - Jacobs, Michael R.
AU - Felmingham, David
AU - Appelbaum, Peter C.
AU - Grüneberg, Reuben N.
AU - Kariuki, S.
AU - Klugman, K.
AU - Urbášková, P.
AU - Hryniewicz, W.
AU - Sidorenko, S. V.
AU - Upková, H.
AU - Theuretzbacher, U.
AU - Verhaegen, J.
AU - Lemozy, J.
AU - Dabernat, H.
AU - Goldstein, F.
AU - Weber, M.
AU - Roussel-Delvallez, M.
AU - Jehl, F.
AU - Grimm, H.
AU - Seewald, M.
AU - Mauch, H.
AU - Giamarellou, H.
AU - Schito, G. C.
AU - Stobberingh, E. E.
AU - Cristino, J. M.
AU - Smyth, E.
AU - Gilleece, A.
AU - Fenelon, L.
AU - Liñares, J.
AU - Bille, J.
AU - Felmingham, D.
AU - Wing Hong, S.
AU - Yamaguchi, K.
AU - Kono, S.
AU - Inoue, M.
AU - Kaku, M.
AU - Yeo, M.
AU - Lin, R.
AU - Keller, N.
AU - Shibl, A. M.
AU - Mendes, C.
AU - Sifuentes-Osornio, J.
AU - Quiñones, F.
AU - Espinosa, L. E.
AU - Alvarez, G.
AU - Ma.Hinojosa, R.
AU - Tinoco, J. C.
AU - Ojeda, F.
AU - Grover, B.
AU - Gamble, S.
AU - Bay, M.
AU - Lamb, D.
AU - Munroe, S.
AU - Teskie, G.
AU - Wong, P.
AU - Cyprian, S.
AU - Cleary, T.
AU - Rivera, M.
AU - Watkins, C.
AU - Phillips, H.
AU - Prince, D.
AU - Walker, S.
AU - Beard, M.
AU - Carey, R.
AU - Droege, B.
AU - Tjhio, J.
AU - Denys, G.
AU - Cheek, R.
AU - Munier, G.
AU - Cato, B.
AU - Eppling, W.
AU - Cosmidis, D.
AU - DeMarco, D.
AU - McDermott, L.
AU - Schwartz, D.
AU - Welty, M.
AU - VanEnk, R.
AU - Loomis, J.
AU - McClure, L.
AU - Temme, L.
AU - Matthey, S.
AU - Hostetter, M.
AU - Buck, L.
AU - Overturf, G.
AU - Cammarata, R.
AU - Jenkins, S.
AU - Rosenstein, L.
AU - DiPersio, J. R.
AU - Jacobs, M.
AU - Hogan, C.
AU - Rourke, B.
AU - Kaufmann, L.
AU - Griffin, J.
AU - Smith, B.
AU - Brown, L.
AU - Cavagnolo, B.
AU - Lee, N.
AU - Mann, L.
AU - Korgenski, K.
N1 - Funding Information:
We acknowledge Laura Koeth for coordinating collecting sites and transport of isolates; Saralee Bajaksouzian, Christine Dencer, Gengrong Lin, Glenn Pankuch, Marion J. Robbins and Anne Windau for expert technical assistance; Ian Harding and Vaughan Reed for data analysis; GlaxoSmithKline for support of the project; and Naomi Richardson for assistance with manuscript preparation. The Alexander Project is supported by an unrestricted educational grant from GlaxoSmithKline. The contributions of the following Alexander Group investigators are acknowledged. Africa: S. Kariuki, K. Klugman. Eastern Europe: P. Urbášková, W. Hryniewicz, S.V. Sidorenko, H. Upková. Western Europe: U. Theuretzbacher, J. Verhaegen, J. Lemozy, H. Dabernat, F. Goldstein, M. Weber, M. Roussel-Delvallez, F. Jehl, H. Grimm, M. Seewald, H. Mauch, H. Giamarellou, G.C. Schito, E.E. Stobber-ingh, J.-M. Cristino, E. Smyth, A. Gilleece, L. Fenelon, J. Liñares, J. Bille, D. Felmingham. Far East: S. Wing Hong, K. Yamaguchi, S. Kono, M. Inoue, M. Kaku, M. Yeo, R. Lin. Middle East: N. Keller, A.M. Shibl. Latin America: C. Mendes, J. Sifuentes-Osornio, F. Quiñones, L.E. Espinosa, G. Alvarez, R. Ma. Hinojosa, J.C. Tinoco, F. Ojeda. USA: B. Grover, S. Gamble, M. Bay, D. Lamb, S. Munroe, G. Teskie, P. Wong, S. Cyprian, T. Cleary, M. Rivera, C. Watkins, H. Phillips, D. Prince, S. Walker, M. Beard, R. Carey, B. Droege, J. Tjhio, G. Denys, R. Cheek, G. Munier, B. Cato, W. Eppling, D. Cosmidis, D. DeMarco, L. McDermott, D. Schwartz, M. Welty, R. VanEnk, J. Loomis, L. McClure, L. Temme, S. Matthey, M. Hos-tetter, L. Buck, G. Overturf, R. Cammarata, S. Jenkins, L. Rosenstein, J.R. DiPersio, M. Jacobs, C. Hogan, B. Rourke, L. Kaufmann, J. Griffin, B. Smith, L. Brown, B. Cavagnolo, N. Lee, L. Mann, K. Korgenski, K. Hazen, W. Winn, J. Claridge, M. Coyle, M. Patera, J. Quick, M. Schmitz.
PY - 2003/8/1
Y1 - 2003/8/1
N2 - Objectives: The Alexander Project is a continuing surveillance study, begun in 1992, examining the susceptibility of pathogens involved in adult community-acquired respiratory tract infections (CARTI) to a range of antimicrobial agents. Materials and methods: This study tested the susceptibility of isolates of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis collected between 1998 and 2000 to 23 antimicrobials. Minimum inhibitory concentrations of agents were determined using the broth microdilution method and interpreted according to NCCLS and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. Results: In total, 8882 isolates of S. pneumoniae, 8523 isolates of H. influenzae and 874 isolates of M. catarrhalis were collected during 1998-2000 from centres in 26 countries. The world-wide prevalence of penicillin resistance (penicillin MICs ≥ 2 mg/L) in isolates of S. pneumoniae was 18.2% over the study period, and the prevalence of macrolide resistance (erythromycin MICs ≥ 1 mg/L) in this pathogen was 24.6%. Over the study period, macrolide resistance exceeded penicillin resistance in 19 of the 26 countries included in the study. Of the non-fluoroquinolone agents, the only oral agents to which over 90% of S. pneumoniae isolates were susceptible at both NCCLS and PK/PD breakpoints were amoxicillin (95.1%) and co-amoxiclav (95.5-97.9%). The prevalence of fluoroquinolone-resistant S. pneumoniae (ofloxacin MICs ≥ 8 mg/L) was 1.1%. Gemifloxacin was the most potent fluoroquinolone tested against S. pneumoniae (99.9% susceptible). In isolates of H. influenzae, β-lactamase production was 16.9%, whereas the prevalence of β-lactamase-negative, ampicillin-resistant strains was low (0.2%). β-Lactamase production in M. catarrhalis world-wide remained high over the period studied (92.1%). Using PK/PD breakpoints, the most active non-fluoroquinolone agents against H. influenzae were ceftriaxone (100% susceptible), cefixime (99.8%) and co-amoxiclav (98.1-99.6%). Co-amoxiclav, cefdinir and cefixime (100%) were the most active β-lactams against M. catarrhalis. Both H. influenzae and M. catarrhalis were highly susceptible to the fluoroquinolones. Conclusions: These data demonstrate the continued evolution of and geographical variation in bacterial resistance and highlight the need for appropriate prescribing of antimicrobials in CARTI, using agents with adequate activity, based on local susceptibility profiles and PK/PD parameters.
AB - Objectives: The Alexander Project is a continuing surveillance study, begun in 1992, examining the susceptibility of pathogens involved in adult community-acquired respiratory tract infections (CARTI) to a range of antimicrobial agents. Materials and methods: This study tested the susceptibility of isolates of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis collected between 1998 and 2000 to 23 antimicrobials. Minimum inhibitory concentrations of agents were determined using the broth microdilution method and interpreted according to NCCLS and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. Results: In total, 8882 isolates of S. pneumoniae, 8523 isolates of H. influenzae and 874 isolates of M. catarrhalis were collected during 1998-2000 from centres in 26 countries. The world-wide prevalence of penicillin resistance (penicillin MICs ≥ 2 mg/L) in isolates of S. pneumoniae was 18.2% over the study period, and the prevalence of macrolide resistance (erythromycin MICs ≥ 1 mg/L) in this pathogen was 24.6%. Over the study period, macrolide resistance exceeded penicillin resistance in 19 of the 26 countries included in the study. Of the non-fluoroquinolone agents, the only oral agents to which over 90% of S. pneumoniae isolates were susceptible at both NCCLS and PK/PD breakpoints were amoxicillin (95.1%) and co-amoxiclav (95.5-97.9%). The prevalence of fluoroquinolone-resistant S. pneumoniae (ofloxacin MICs ≥ 8 mg/L) was 1.1%. Gemifloxacin was the most potent fluoroquinolone tested against S. pneumoniae (99.9% susceptible). In isolates of H. influenzae, β-lactamase production was 16.9%, whereas the prevalence of β-lactamase-negative, ampicillin-resistant strains was low (0.2%). β-Lactamase production in M. catarrhalis world-wide remained high over the period studied (92.1%). Using PK/PD breakpoints, the most active non-fluoroquinolone agents against H. influenzae were ceftriaxone (100% susceptible), cefixime (99.8%) and co-amoxiclav (98.1-99.6%). Co-amoxiclav, cefdinir and cefixime (100%) were the most active β-lactams against M. catarrhalis. Both H. influenzae and M. catarrhalis were highly susceptible to the fluoroquinolones. Conclusions: These data demonstrate the continued evolution of and geographical variation in bacterial resistance and highlight the need for appropriate prescribing of antimicrobials in CARTI, using agents with adequate activity, based on local susceptibility profiles and PK/PD parameters.
KW - Antimicrobial resistance
KW - Community-acquired respiratory tract infection
KW - Haemophilus influenzae
KW - Moraxella catarrhalis
KW - Streptococcus pneumoniae
KW - Surveillance
UR - http://www.scopus.com/inward/record.url?scp=0043156138&partnerID=8YFLogxK
U2 - 10.1093/jac/dkg321
DO - 10.1093/jac/dkg321
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C2 - 12865398
AN - SCOPUS:0043156138
SN - 0305-7453
VL - 52
SP - 229
EP - 246
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 2
ER -