文献荟萃
Abstract
The GLOBAL (Global Landscape On the Bactericidal Activity of Levofloxacin) Surveillance Program is a worldwide initiative intended to detect changes in resistance among common respiratory tract pathogens. In the 2007 study period, a total of 2,395 isolates of Streptococcus pneumoniae ( S. pneumoniae) and 2,287 Haemophilus influenzae ( H. influenzae ) were collected from 12 countries in Asia and Europe and tested for susceptibility to com -monly used antimicrobial agents. Among the evaluated pneumococci, penicillin and azithromycin resistance were more predominant in Asia. Penicillin susceptibility was 42.1% in Asia compared with 75.5% in Europe. Azithromycin susceptibility was only 21.5% in Asia compared with 67.3% in Eu -rope—a 5% decrease in azithromycin susceptibility was seen in both Asia and Europe in 2005 com -pared with 1997–1999. Multidrug resistance was also more prevalent among pneumococci in Asia. One-third of all pneumococcal isolates from Asia exhibited resistance to four antimicrobials tested (penicillin, azithromycin, cefuroxime, and trimethoprim/sulfamethoxazole) compared with only 6.6% of isolates from Europe. Multidrug resistance rates also varied greatly among specific countries in each region. In contrast to other agents, levofloxacin remained highly active against the evaluated pneumo -cocci regardless of resistance phenotype, including multidrug-resistance, and maintained a consistent MIC50 and MIC90 of 1 μg/ml over time. H. influenzae remained largely susceptible to the evaluated oral agents, excluding trimethoprim/sulfamethoxazole where resistance ranged from 30 to 60%, primarily among the evaluated Asian countries. β-lacatamase varied by country but again was high in parts of Asia (40–60% in Taiwan and South Korea). As with pneumococci, H. influenzae remained >99.9% susceptible to levofloxacin regardless of resistance phenotype.