TY - JOUR T1 - Surveillance of antibiotic resistance in non invasive clinical isolates of Streptococcus pneumoniae collected in Belgium during winters 2003 and 200436771 JF - Acta Clin.Belg. Y1 - 2006 A1 - R. Vanhoof A1 - Carpentier,M. A1 - Cartuyvels,R. A1 - Damee,S. A1 - Fagnart,O. A1 - Frans,J. A1 - Gordts,B. A1 - Y. Glupczynski A1 - Goffinet,P. A1 - Govaerts,D. A1 - P. Lefevre A1 - Lontie,M. A1 - Magerman,K. A1 - Mans,I. A1 - Meunierz,F. A1 - Moonens,F. A1 - Surmont,I. A1 - Van Bossuyt,E. A1 - Van de Vyvere,M. A1 - Van Eldere,J. A1 - Van Landuyt,H. A1 - Van Nimmen,L. A1 - Van Noyen,R. A1 - Jan Verhaegen KW - 0 KW - 2004 KW - a KW - acid KW - admission KW - age KW - Agent KW - Agents KW - ALL KW - Amoxicillin KW - Ampicillin KW - an KW - Anti-Bacterial Agents KW - Antibiotic KW - Antibiotic resistance KW - article KW - AS KW - Belgium KW - beta-Lactams KW - care KW - Cefotaxime KW - Ceftazidime KW - Chi-Square Distribution KW - Ciprofloxacin KW - Clindamycin KW - Clinical KW - Common KW - Comparative Study KW - Data collection KW - Diagnosis KW - differences KW - drug effects KW - Drug Resistance,Multiple,Bacterial KW - drug therapy KW - epidemiology KW - Erythromycin KW - Female KW - Follow KW - Gender KW - Geographic KW - Humans KW - im KW - IS KW - isolation & purification KW - journal KW - Laboratories KW - long term care KW - Long-term KW - long-term care KW - long-term care facilities KW - Male KW - Microbial Sensitivity Tests KW - ON KW - ORIGIN KW - Patient KW - patients KW - pharmacology KW - Phenotype KW - Pneumococcal Infections KW - present KW - Print KW - r KW - RATES KW - recommendation KW - Recommendations KW - resistance KW - Sample KW - Sampling Studies KW - SB - IM KW - Sensitivity and Specificity KW - Streptococcus pneumoniae KW - study KW - Surveillance KW - survey KW - surveys KW - Technique KW - Tetracycline KW - Type KW - Winter AB - 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 O/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 microg/ml, 0.12 microg/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 beta-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) VL - 61 CP - 2 U1 - 36771 ER -