Surveillance of antibiotic resistance in non invasive clinical isolates of streptococcus pneumoniae collected in Belgium during winters 2003 and 2004

VANHOOF R;CARPENTIER M;CARTUYVELS R;DAMÉE S;FAGNART O;FRANS J;GORDTS B;GLUPCZYNSKI Y;GOFFINET P;GOVAERTS D;LEFÈVRE P;LONTIE M;MAGERMAN K;MANS I;MEUNIER F;MOONENS F;SURMONT I;VAN BOSSUYT E;VAN DE VYVERE M;VAN ELDERE J

Document Details :

Title: Surveillance of antibiotic resistance in non invasive clinical isolates of streptococcus pneumoniae collected in Belgium during winters 2003 and 2004
Author(s): VANHOOF R, CARPENTIER M, CARTUYVELS R, DAMÉE S, FAGNART O, FRANS J, GORDTS B, GLUPCZYNSKI Y, GOFFINET P, GOVAERTS D, LEFÈVRE P, LONTIE M, MAGERMAN K, MANS I, MEUNIER F, MOONENS F, SURMONT I, VAN BOSSUYT E, VAN DE VYVERE M, VAN ELDERE J
Journal: Acta Clinica Belgica
Volume: 61 Issue: 2 Date: 2006
Pages: 49-57
DOI: 10.2143/ACB.61.2.1002673

Abstract :

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 %), evofloxacin 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 2.3/22.1 % (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 signifi cantly 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 insusceptible isolates were 14, 23, 19 and 9 (20.0 %, 20.0 %, 16.4 % and 10.9 % respectively in 2003; 41.6 %, 11.7 %, 15.0 % and 18.3 % respectively in 2004).