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ABSTRACTThe macrolide and levofloxacin susceptibilities of 992 isolates of Streptococcus pneumoniaefrom clinical specimens collected in 1999 and 2000 were determined in 10 centers in Central and Eastern European countries. The prevalences of penicillin G-intermediate (MICs, 0.125 to 1 μg/ml) and penicillin-resistant (MICs, ≤2 μg/ml) Streptococcus pneumoniaeisolates were 14.3 and 16.6%, respectively. The MICs at which 50% of isolates are inhibited (MIC50s) and the MIC90s of telithromycin were 0.016 and 0.06 μg/ml, respectively; those of erythromycin were 0.06 and >64 μg/ml, respectively; those of azithromycin were 0.125 and >64 μg/ml, respectively; those of clarithromycin were 0.03 and >64 μg/ml, respectively; and those of clindamycin were 0.06 and >64 μg/ml, respectively. Erythromycin resistance was found in 180 S. pneumoniaeisolates (18.1%); the highest prevalence of erythromycin-resistant S. pneumoniaewas observed in Hungary (35.5%). Among erythromycin-resistant S. pneumoniaeisolates, strains harboring erm(B) genes (125 strains [69.4%]) were found to be predominant over strains with mef(E) genes (25 strains [13.4%]), L4 protein mutations (28 strains [15.6%]), and erm(A) genes (2 strains [1.1%]). Similar pulsed-field gel electrophoresis patterns suggested that some strains containing L4 mutations from the Slovak Republic, Bulgaria, and Latvia were clonally related. Of nine strains highly resistant to levofloxacin (MICs, >8 μg/ml) six were isolated from Zagreb, Croatia. Telithromycin at ≤0.5 μg/ml was active against 99.8% of S. pneumoniaeisolates tested and may be useful for the treatment of respiratory tract infections caused by macrolide-resistant S. pneumoniaeisolates.

ABSTRACTAmong 1,011 recently isolated Streptococcus pyogenesisolates from 10 Central and Eastern European centers, the MICs at which 50% of isolates are inhibited (MIC50s) and the MIC90s were as follows: for telithromycin, 0.03 and 0.06 μg/ml, respectively; for erythromycin, azithromycin, and clarithromycin, 0.06 to 0.125 and 1 to 8 μg/ml, respectively; and for clindamycin, 0.125 and 0.125 μg/ml, respectively. Erythromycin resistance occurred in 12.3% of strains. Erm(A) [subclass erm(TR)] was most commonly encountered (60.5%), followed by mef(A) (23.4%) and erm(B) (14.5%). At <0.5 μg/ml, telithromycin was active against 98.5% of the strains tested.

With use of standardized techniques, a study of nasopharyngeal pneumococcal carriage in children in six Central and Eastern European cities was undertaken during the winter of 1993–1994. Nasopharyngeal swab specimens were collected from 954 children (predominantly under the age of 5 years) who were hospitalized or attending outpatient clinics or day-care centers. Susceptibility of isolates was determined by disk diffusion (on Mueller-Hinton agar with 5% sheep blood). Disks containing 1 µg of oxacillin were used to screen for susceptibility to penicillin G. Pneumococci were recovered from 258 (27.0%) of the 954 children. A variety of strains were recovered, and most penicillin-resistant strains were resistant to multiple agents. Minimum inhibitory concentrations of penicillin for selected resistant strains were 0.125–8 µg/mL. Resistance to penicillin was common in strains from Bulgaria, Romania, and Slovakia. Resistance to erythromycin and chloramphenicol occurred in Bulgarian and Romanian strains. Strains from Poland were all susceptible to penicillin, but many were resistant to tetracycline. Resistance to trimethoprim-sulfamethoxazole was common in Bulgarian, Romanian, and Slovak strains. Czech and Russian strains were predominantly susceptible to antibiotics. Most resistant strains were of serotypes 6, 14, 19, and 23.