SURVEILLANCE OF ANTIBIOTIC RESISTANCE IN NON INVASIVE CLINICAL ISOLATES OF STREPTOCOCCUS PNEUMONIAE COLLECTED IN BELGIUM DURING WINTERS 2003 AND 2004

A total of 391 and 424 non-invasive isolates of Streptococcus pneumoniae collected by 15 laboratories during the 2003 and 2004 survey were tested for their susceptibility by a microdilution technique following NCCLS recommendations. Insusceptibility rates (IR) in the two surveys (2003/2004) were as...

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Published in:Acta clinica belgica (English ed. Online) 2006-03, Vol.61 (2), p.49-57
Main Authors: Vanhoof, R., Carpentier, M., Cartuyvels, R., Damée, S., Fagnart, O., Frans, J., Gordts, B., Glupczynski, Y., Goffinet, P., Govaerts, D., Lefèvre, Ph, Lontie, M., Magerman, K., Mans, I., Meunier, F., Moonens, F., Surmont, I., Van Bossuyt, E., Van De Vyvere, M., Van Eldere, J., Van Landuyt, H., Van Nimmen, L., Van Noyen, R., Verhaegen, J.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - pharmacology
Belgium - epidemiology
Chi-Square Distribution
Data Collection
Drug Resistance, Multiple, Bacterial
Female
Humans
Male
Microbial Sensitivity Tests
Pneumococcal Infections - diagnosis
Pneumococcal Infections - drug therapy
Pneumococcal Infections - epidemiology
Resistance
S. pneumoniae
Sampling Studies
Sensitivity and Specificity
Streptococcus pneumoniae - drug effects
Streptococcus pneumoniae - isolation & purification
Surveillance
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Summary:A total of 391 and 424 non-invasive isolates of Streptococcus pneumoniae collected by 15 laboratories during the 2003 and 2004 survey were tested for their susceptibility by a microdilution technique following NCCLS recommendations. Insusceptibility rates (IR) in the two surveys (2003/2004) were as follows: penicillin 15.0/14.7 % [8.4/6.4 % Resistance (R)], ampicillin 17.4/14.6 % (R 9.0/7.1 %), amoxicillin ± clavulanic acid 2.6/1.2 % (R 0/0 %), cefaclor 14.3/14.1 % (R 11.5/13.4 %), cefuroxime 13.6/12.7 % (R 10.5/11.8 %), cefuroxime-axetil 10.5/11.8 % (R 10.0/9.2 %) (breakpoints based on 250 mg), cefotaxime 4.9/6.2 % (R 1.3/2.4 %), ceftazidime NotTested (NT)/6.4 (R NT/2.6 %), cefepime NT/6.4 (R NT/2.6 %), imipenem 7.7/8.9 % (R 1.8/1.4 %), ertapenem 0.8/NT % (R 0/NT %), ciprofloxacin 13.8/9.0 % (R 4.3/2.4 %), levofloxacin 3.3/2.8 % (R 1.5/0.2 %), moxifloxacin 0.6/0.2 % (R 0.3/0 %), ofloxacin 13.5/9.0 % (R 4.3/2.4 %), erythromycin 26.1/24.7 % (R 25.3/24.5 %), azithromycin 25.4/24.7 % (R 24.6/24.5 %), telithromycin 0.8/0.2 % (R 0.5/0 %), clindamycin 21.2/18.4 % (R 19.2/17.7 %) and tetracycline 32.3/22.1 % (R 29.2/19.3 %). There were only minor differences in resistance rates according to age, sample site, admission type (i.e. ambulatory, hospitalized or long-term care facility patients), gender and geographic origin. Overall, telithromycin (MIC50, MIC90 in 2003/2004: 0.015 µg/ml, 0.12 µg/ml/ 0.008,0.06 respectively), ertapenem (0.03; 0.25/NT), moxifloxacin (0.06; 0.25/0.06, 0.12), and amoxicillin ± clavulanic acid (0.03; 0.25/0.015, 0.5) were the most active compounds in both surveys. In 2003, the most common resistance phenotype was isolated insusceptibility to tetracycline (10.5 %) followed by combined insusceptibility to erythromycin and tetracycline (9.3 %). Erythromycin-tetracycline resistance (10.4 %) was the most common in 2004. Isolates showing resistance to an antibiotic were significantly more present in 2003 than in 2004 (50.4 % versus 40.8 %). In penicillin-insusceptible isolates, MICs of all beta-lactams were increased but cross-resistance between penicillin and other β-lactams in the penicillin-insusceptible isolates was not complete. In the 2003 survey, most of these isolates remained fully susceptible to ertapenem (94.9 %) and amoxicillin ± clavulanic acid (83.1 %). In the 2004 survey, 91.9 % of the penicillin insusceptible isolates remained susceptible to amoxicillin ± clavulanic acid. In both surveys, the most common serotypes in penicillin i
ISSN:1784-3286
2295-3337
DOI:10.1179/acb.2006.010