Journal Article

Factors Associated with Relative Rates of Antimicrobial Resistance among <i>Streptococcus pneumoniae</i> in the United States: Results from the TRUST Surveillance Program (1998–2002)

James A. Karlowsky, Clyde Thornsberry, Mark E. Jones, Alan T. Evangelista, Ian A. Critchley and Daniel F. Sahm

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 36, issue 8, pages 963-970
Published in print April 2003 | ISSN: 1058-4838
Published online April 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/374052
Factors Associated with Relative Rates of Antimicrobial Resistance among Streptococcus pneumoniae in the United States: Results from the TRUST Surveillance Program (1998–2002)

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To identify factors associated with antimicrobial resistance, data were analyzed from 27,828 isolates of Streptococcus pneumoniae submitted to the Tracking Resistance in the United States Today (TRUST) surveillance program during 4 consecutive respiratory seasons. From the 1998–1999 season to the 2001–2002 season, the prevalence of azithromycin resistance increased by 4.8% to 27.5%, the prevalence of penicillin resistance increased by 3.7% to 18.4%, the prevalence of ceftriaxone resistance increased by 0.5% to 1.7%, and the prevalence of levofloxacin resistance increased by 0.3% to 0.9%. Isolates recovered from patients <18 years of age and lower respiratory tract specimens had elevated rates of penicillin, azithromycin, and trimethoprim-sulfamethoxazole resistance (P < .00001); penicillin resistance correlated with coresistance to trimethoprim-sulfamethoxazole (87.3%), azithromycin (76.3%), ceftriaxone (9.1%), and levofloxacin (1.3%) (P < .00001). Only 62 (0.2%) of 27,828 isolates were concurrently resistant to penicillin and levofloxacin. Minimum inhibitory concentrations (MICs) of penicillin correlated strongly with MICs of ceftriaxone (R2 = 0.90), trimethoprim-sulfamethoxazole (R2 = 0.53), and azithromycin (R2 = 0.41). Patient age, specimen source, and penicillin resistance were factors associated with antimicrobial resistance, particularly for nonfluoroquinolone antimicrobial agents.

Journal Article.  4449 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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