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Year: 2003  Vol. 7   Num. 2  - Apr/June Print:
Original Article
Texto Text in Portuguese
Respiratory Tract Infections: Major Bacterial Pathogens and Patterns of Resistance. Brazilian Results from PROTEKT Surveillance Study
Infecções do Trato Respiratório: Principais Agentes Bacterianos e Padrões de Resistência. Dados Brasileiros do Estudo Internacional PROTEKT
Author(s):
Caio Mendes*, André Hsiung**, Christine Dencer***, David Felmingham****, Flávia Rossi*****, Adília Jane Alcântara Segura******, Cássia Maria Zoccoli******, Hélio Sader********, Igor Mimica*********.
Key words:
espiratory tract, antimicrobial resistance, main pathogens.
Abstract:

Introduction: Respiratory tract infections (RTI) are a common occurrence and responsible for significant morbidity and mortality. The empiric treatment is often administered due to the diversity of etiological agents and difficulty in diagnosis. Objective: To evaluate the main pathogens responsible for community-acquired RTI in Brazil and the resistance patterns against antimicrobials, as part of the PROTEKT surveillance study. Materials and Methods: 960 bacterial isolates from community patients with diagnosis of RTI. Results: Among the 260 S. pneumoniae, penicillin G resistance was found in 33.8% of isolates (8% full resistance). It was also observed a certain degree of resistance (6,5%) to the macrolides. However, all S. pneumoniae evaluated were susceptible to £ 1.0 mg/µL of telithromycin. Among the 273 H. influenzae, 11% were b-lactamase producers and there was a high rate of resistance to cotrimoxazol (I+R=41,%). All these strains presented MIC £ 4.0 mg/µL to telithromycin. In M. catarrhalis (n=71), 98,6% were b-lactamase positive and all strains were susceptible to telithromycin. All S. pyogenes (n=145) were susceptible to penicillin. There was a slight resistance towards the macrolides in 5.5% of isolates. The MIC 90 of these strains for telithromycin was 0.015 mg/µL. Among the 211 S. aureus isolates, 97,2% of the strains susceptible to oxacillin were susceptible to telithromycin. Conclusion: This study presents the current prevalence of community RTI pathogens in Brazil and their susceptibility patterns towards several antimicrobials. Telithromycin, the first ketolide to be approved for clinical use, has excellent in vitro activity against the CARTI pathogens studied.

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