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Multidrug-Resistant Streptococcus pneumoniae (MDRSP) in U.S. Adult Patients: A 2003 Local Perspective FREE TO VIEW

Renee Blosser, MS; Mark E. Jones, PhD*; Robert K. Flamm, PhD; Glenn S. Tillotson, PhD; David A. Styers, BS; Ronald N. Master, MS; Daniel F. Sahm, PhD
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Focus Technologies, Inc., Herndon, VA


Chest. 2004;126(4_MeetingAbstracts):849S. doi:10.1378/chest.126.4_MeetingAbstracts.849S
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PURPOSE:  Respiratory infections caused by MDRSP are an important global issue facing physicians, the response to which has been the development and approval of some antimicrobials (e.g., gemifloxacin [GEM]) for the treatment of MDRSP. Monitoring local changes in the prevalence of MDRSP and in the efficacy of new agents on a continual basis is therefore important. We examined the current prevalence of MDRSP in the U.S. in adults geographically and by patient age.

METHODS:  TSN Database-USA (2003 only) was used to evaluate the current prevalence of MDRSP in 9 geographic regions of the U.S. (Atlanta, Baltimore/DC, Carolinas, Central Florida, Chicago, Dallas, Los Angeles, Ohio, South Florida). The prevalence of MDRSP from these regions combined was also analyzed according to patient age (18–44 y, 45–65 y, >65 y). MDR was defined as resistance (R) to ≥2 among PEN, erythromycin (ERY), and trimethoprim-sulfamethoxazole (SXT). In addition, we selected 30 MDRSP strains to evaluate the in vitro activities of respiratory fluoroquinolones (GEM, gatifloxacin [GAT], moxifloxacin [MXF], and levofloxacin [LFX]).

RESULTS:  Overall, 19.2% of the SP collected were MDR; R to PEN, ERY, and SXT was the most common MDR phenotype. By region, MDR was lowest in Los Angeles (9.1%) and highest in South Florida (32.2%); MDR was >20% in Baltimore/DC, Central Florida, and Dallas. According to patient age, MDR was lowest among SP collected from patients 18–44 y (10.4%), compared with patients 45–65 y (19.6%) and >65 y (24.2%). R to PEN, ERY, and SXT was the most common MDR phenotype encountered in all patient age groups. For the 30 MDRSP centrally tested, the fluoroquinolone MIC ranges were as follows: 0.008–0.03 mg/L (GEM), 0.12–0.25 mg/L (GAT), 0.06–0.25 mg/L (MXF), 0.5–1 mg/L (LFX).

CONCLUSION:  MDRSP in adults is an important issue faced in both the hospital and community settings and shows an increased prevalence with an increase in patient age.

CLINICAL IMPLICATIONS:  GEM was the most active fluoroquinolone tested against MDRSP and should continue to be monitored as it is introduced into clinical use.

DISCLOSURE:  M.E. Jones, None.

Wednesday, October 27, 2004

12:30 PM- 2:00 PM




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