Antimicrobial Resistance Data on 16,756Streptococcus pneumoniaeIsolates in 1999: A Pan-Regional Multicenter Surveillance Study in France

Abstract

The rising prevalence of antibiotic-resistant Streptococcus pneumoniae is a phenomenon observed to different degrees around the world. The present national surveillance study report analyzes a total of 16,756 strains of S. pneumoniae collected across France in 1999. The overall prevalence of S. pneumoniae with decreased susceptibility to penicillin was 44%, to amoxicillin 26%, and to cefotaxime 17%. The proportion of high-level resistant strains to penicillin (MIC > 1 mg/L), amoxicillin and cefotaxime (MIC > 2 mg/L) remained low: 12.3%, 1.8%, and 0.4% respectively. Prevalence of resistance to other antibiotics was high: 53% to erythromycin, 41.7% to cotrimoxazole, 31.8% to tetracycline, and 24.6% to chloramphenicol. Prevalence of penicillin-resistant S. pneumoniae varied according to subject age and specimen source. It was higher in children (52.7%) than in adults (39.8%) and higher in strains isolated from middle ear fluid (63.6%) than from blood cultures (41.8%) in children. S. pneumoniae resistant to other antibiotics were more common in children than in adults, although figures showed geographical variations. Comparison with a previous study realized in 1997 in the same regions confirms a rising trend in the prevalence of resistant bacteria. Therefore, we conclude that prevalence of antibiotic-resistant S. pneumoniae in 1999 continued to rise in France, although strains with high-level resistance to penicillin remained stable.

Social-economic factors and irrational antibiotic use as reasons for antibiotic resistance of bacteria causing common childhood infections in primary healthcare

“…Penicillin-resistant strains were statistically significantly more often isolated in children under the age of 5 compared to children 5-17 years of age (32.2%:21.0%, p<0.001) [86]. The resistance of Streptococcus pneumoniae to penicillin in children (patients under the age of 18 years) in outpatient conditions in France was 1.3 times higher than in adults (patients aged over 18 years) (52.7%:39.8%) [19]. In a pediatric hospital in Saudi Arabia, the rate of intermediately penicillin-susceptible isolates in children under 2 years of age was almost two times higher as compared to children 2 to 17 years of age (41.9%:22.7%, p= 0.02).…”

“…All isolates were susceptible to ceftriaxone and vancomycin [3]. According to the results of a study conducted in children in France, Streptococcus pneumoniae isolated from middle ear was 1.5 times more resistant to penicillin than blood culture isolates (63.6%:41.8%) [19].…”

Neonatal and Infantile Immune Responses to Encapsulated Bacteria and Conjugate Vaccines

“…Pneumococcal vaccines that are effective in infants have been welcomed as resistance against growing commonly used antibiotics [51]. An unconjugated 23-valent vaccine is registered for children over two years of age but is ineffective in younger children [52].…”