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Antimicrobial Agents and Chemotherapy, September 2002, p. 2963-2968, Vol. 46, No. 9
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.9.2963-2968.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Antistreptococcal Activity of Telithromycin Compared with Seven Other Drugs in Relation to Macrolide Resistance Mechanisms in Russia

Roman S. Kozlov,1 Tatiana M. Bogdanovitch,1 Peter C. Appelbaum,2 Lois Ednie,2 Leonid S. Stratchounski,1 Michael R. Jacobs,3 and Bülent Bozdogan2*

Institute of Antimicrobial Chemotherapy, Smolensk, Russia,1 Department of Pathology, Hershey Medical Center, Hershey, Pennsylvania,2 Case Western Reserve University, Cleveland, Ohio3

Received 7 January 2002/ Returned for modification 16 April 2002/ Accepted 17 May 2002

The susceptibilities of 468 recent Russian clinical Streptococcus pneumoniae isolates and 600 Streptococcus pyogenes isolates, from 14 centers in Russia, to telithromycin, erythromycin, azithromycin, clarithromycin, clindamycin, levofloxacin, quinupristin-dalfopristin, and penicillin G were tested. Penicillin-nonsusceptible S. pneumoniae strains were rare except in Siberia, where their prevalence rate was 13.5%: most were penicillin intermediate, but for three strains (two from Smolensk and one from Novosibirsk) the MICs of penicillin G were 4 or 8 µg/ml. Overall, 2.5% of S. pneumoniae isolates were resistant to erythromycin. Efflux was the prevalent resistance mechanism (five strains; 41.7%), followed by ribosomal methylation encoded by constitutive erm(B), which was found in four isolates. Ribosomal mutation was the mechanism of macrolide resistance in three isolates; one erythromycin-resistant S. pneumoniae isolate had an A2059G mutation in 23S rRNA, and two isolates had substitution of GTG by TPS at positions 69 to 71 in ribosomal protein L4. All S. pyogenes isolates were susceptible to penicillin, and 11% were erythromycin resistant. Ribosomal methylation was the most common resistance mechanism for S. pyogenes (89.4%). These methylases were encoded by erm(A) [subclass erm(TR)] genes, and their expression was inducible in 96.6% of isolates. The rest of the erythromycin-resistant Russian S. pyogenes isolates (7.6%) had an efflux resistance mechanism. Telithromycin was active against 100% of pneumococci and 99.2% of S. pyogenes, and levofloxacin and quinupristin-dalfopristin were active against all isolates of both species.

* Corresponding author. Mailing address: Department of Pathology, Hershey Medical Center, Mail code H083, 500 University Dr., Hershey, PA 17033. Phone: (717) 531-3910. Fax: (717) 531-7953. E-mail: bozdogan-b{at}psu.edu.

Antimicrobial Agents and Chemotherapy, September 2002, p. 2963-2968, Vol. 46, No. 9
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.9.2963-2968.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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