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TARGET Surveillance, a part of the LIBRA initiative: comparative activity of moxifloxacin against respiratory pathogens isolated during 2003

Abstract number: 1134_04_124

Morrissey I., McKeon M., Dowling K., Colclough A., Viljoen L., Veltman T.

Objectives:  

To assess the antibiotic (ABX) susceptibility of H. influenzae (HI) & S. pneumoniae (SP) isolates causing community-acquired respiratory-tract infections (CARTI) in 2003.

Methods:  

51 centres in 7 countries submitted 2925 HI and 3233 SP. MICs for penicillin G (PEN, SP only), ampicillin (AMP, HI only), amoxycillin–clavulanate (AMX/C), azithromycin (AZI), ceftriaxone (CTX), levofloxacin (LEV), gatifloxacin (GATI) & moxifloxacin (MXF) were determined by microbroth dilution.

Results:  

All HI were susceptible to AMX/C, CTX, LEV, GATI & MXF. Beta-lactamase prevalence in HI was: France (32.8%), USA (30.6%), Mexico (21.6%), Spain (15.2%), Germany (8.6%), Italy (6.6%), & South Africa (7.8%). Fourteen AZI non-susceptible HI were also found (0.5%). SP resistance (number of centres, isolates per country) is shown below:

  % res
 PDD subset (N)PENAZIAMX/CCTXLEVGATIMXF
-Tot pop (3233)22.134 05 01.81.31.10 3
Age0-1 years (424)38.449.812.54.50.20.20
 2-5 years (317)30.040.78.54.40.300
 6-17 years (224)(21.0)28.66.7(2.7)(0.9)(0.9)(0.5)
 18-64 years (1359)18.0(30.6)2.9(0.8)(1.8)(1.5)(0.3)
 >64 years (884)17.8(30.2)2.8(0.9)(1.4)(1.2)(0.5)
SourceEar (330)30.043.010.6(3.6)(1.2)(1.2)(0.3)
 Sinus aspirate (176)30.044.99.7(2.8)(0.6)(0.6)0
InfectionAcute otitis   media (306) 28.844.810.5NSNSNSNS
 Chronic ottis   media (63)36.5(36.5)12.74.8000
 Acute sinusitis (217) (21.2)(35.5)(5 1)(3.2)000
 Acute tonsillitis (119)(20.2)(31.1)(8.0)(4.0)(0.8)00

Conclusion:  

Full ABX susceptibility was seen with HI except AMP due to beta-lactamase. However, universal susceptibility to AZI is no longer guaranteed. With SP, AZI and/or PEN resistance was high in many countries. Relatively high AMX/C & CTX resistance was also found in South Africa. SP from Germany had very low ABX resistance but resistance to AZI was observed. Although fluoroquinolone resistance was low, there was evidence of a gap emerging between LEV or GATI and MXF. This was most prominent in Italy where LEV & GATI resistance was highest. MXF is therefore an important option for the treatment of CARTI especially where resistance to other ABX is high.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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