Prevalence of antimicrobial resistances in Streptococcus pneumoniae in Australia, 2005: Report from the Australian Group on Antimicrobial Resistance
DOI:
https://doi.org/10.33321/cdi.2008.32.23Keywords:
antibiotic resistance, epidemiology, Streptococcus pneumoniaeAbstract
In 2005 the Australian Group for Antimicrobial Resistance (AGAR) conducted a survey of the prevalence of antimicrobial resistance in unique clinical isolates of Streptococcus pneumoniae. Twenty laboratories from the 5 mainland states and the Australian Capital Territory collected 1,776 isolates prospectively and tested them by disk diffusion, Etest® and/or agar dilution against a range of antimicrobials. Data from this survey were compared with AGAR surveys conducted in 1989, 1994, 1999 and 2002. Non-susceptibility to penicillin was detected in 28.0% of isolates, 22.7% were erythromycin resistant, 15.6% clindamycin resistant, 18.4% tetracycline resistant and 31.0% trimethoprim-sulphamethoxazole resistant. Levofloxacin resistance was detected in only 4 of 1,775 (0.2%) isolates tested. Intermediate resistance to levofloxacin was detected in another 4 isolates. Moxifloxacin resistance was present in 2 isolates with minimum inhibitory concentrations of 3 mg/L and 4 mg/L. Seventeen point three per cent of isolates were multi-resistant (acquired resistance to more than 2 drug classes). Trend data show an increase in penicillin non-susceptible strains in each survey from 1989 to 2005. Between 1999 and 2005 the proportion of invasive strains with high-level resistance increased from 2.6% to 5.4%. After a rapid emergence and rise in resistance between 1989 and 1999, recent studies have documented a continuing rise in resistance to all non-ß-lactams except trimethoprim-sulphamethoxazole. Commun Dis Intell 2008;32:242–249.
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References
Musher D. Streptococcus pneumoniae. In Mandell G, Bennett J, Dolin R, eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases, 6th edn. Churchill Livingstone, Philadelphia, Pa: p. 2392–2411 2005.
Clinical and Laboratory Standards Institute. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Approved standard; 7th edn. M7–A7. CLSI, Villanova, PA, USA: 2006.
National Committee on Clinical Laboratory Standards. Performance standards for antimicrobial disk susceptibility tests: approved standard – 8th edn. M2–A8. NCCLS, Wayne, PA, USA: 2003.
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 15th Informational Supplement. M100–S16. CLSI, Villanova, PA, USA: 2006.
Bell S, Gatus B, Pham J, Rafferty D. Antibiotic susceptibility testing by the CDS method: A manual for medical and veterinary laboratories; 3rd edn 2004. Available from: http://www.med.unsw.edu.au/pathology-cds
BSAC disc diffusion method for antimicrobial testing. Version 3.1 2004. Available from: http://www.bsac.org.uk
Collignon P, Bell J. Streptococcus pneumoniae: how common is penicillin resistance in Australia? J Aust N Z Med 1992;22:473–476.
Collignon P, Bell J, on behalf of the Australian Group for Antimicrobial Resistance (AGAR). Drug-resistant Streptococcus pneumoniae: the beginning of the end for many antibiotics? Med J Aust 1996;164:64–67.
Nimmo G, Bell J, Collignon P, on behalf of the Australian Group for Antimicrobial Resistance. Fifteen years of surveillance by the Australian Group for Antimicrobial Resistance. Commun Dis Intell 2003;27:547–554.
Roche P, Krause V, Cook H. Invasive pneumococcal disease in Australia, 2005. Commun Dis Intell 2007;31:31;86–100
Therapeutic guidelines: antibiotic. Thirteenth edn. Melbourne: Therapeutic Guidelines Ltd; 2006.
Peterson L. Penicillins for treatment of pneumococcal pneumonia: Does in vitro resistance really matter? Clin Infect Dis 2006;42:224–233.
Chiou C. Does penicillin remain the drug of choice for pneumococcal pneumonia in view of emerging in vitro resistance? Clin Infect Dis 2006;42:234–237.
Daneman N, McGeer A, Green K, Low D. Macrolide resistance in bacteraemic pneumococcal disease: implications for patient management. Clin Infect Dis 2006;43:432–438.
Lonks J, Garau J, Medeiros A. Implications of antimicrobial resistance in the empirical treatment of community-acquired respiratory acquired respiratory tract infections: the case for macrolides. J Antimicrob Chemother 2002;50 Suppl 2:87–92.
Goldstein E, Garabedian-Ruffalo S. Widespread use of fluoroquinolones versus emerging resistance in pneumococci. Clin Infect Dis 2002;35:1505–1511.
Chen D, McGeer A, de Azavedo J, Low D. Decreased susceptibility of Streptococcus pneumoniae to fluoroquinolones in Canada. N Engl J Med 1999;341:233–239.
Pallares R, Fenoll A, Liñares J, The Spanish Pneumococcal Infection Study Network. The epidemiology of antibiotic resistance in Streptococcus pneumoniae and the clinical relevance of resistance to cephalosporins, macrolides and quinolones. Int J Antimicrob Agents 2003;22:S15–S24.
Davidson R, Cavalcanti R, Brunton J, Bast D, Azavedo J, Kibsey P, et al. Resistance to levofloxacin and failure of treatment of pneumococcal pneumonia. N Engl J Med 2002;346:747–750.
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