Antimicrobial resistance of Streptococcus pneumoniae in Southeast Austria, 1997–2008

Abstract

Antibiotic resistance in Streptococcus pneumoniae has increased worldwide but varies within geographical regions. We conducted a retrospective analysis of resistance in S. pneumoniae over a 12-year period to assess local and temporal trends in antibacterial resistance. From 1997 to 2008, a total of 1814 non-duplicate S. pneumoniae isolates were identified at the Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Austria. Antibiotic resistance was determined by the Clinical and Laboratory Standards Institute (CLSI) disk diffusion test. For penicillin, the minimum inhibitory concentration was determined by Etest. Susceptibility was defined according to CLSI interpretive criteria. For penicillin, resistance rates were consistently low at 0.2% over the 12-year study period. An increase in resistance was remarkable for erythromycin (3.5% in 1997; 14.7% in 2008), clindamycin (1.8% in 1997; 10.6% in 2008) and tetracycline (1.8% in 2000; 11.0% in 2008). For trimethoprim/sulfamethoxazole, resistance increased slightly to 9.2% in 2008. Quinolones showed a low resistance rate of 0.2% that persisted over the whole study period. In contrast to previously published national data, resistance to penicillin was observed to remain at a remarkably low and constant level. Although international surveillance programmes have set up sustainable and interlinked data networks, our results suggest that regional surveillance may still be needed as decision support for appropriate empirical antibiotic therapy in the local health setting.

Serotype distribution and antibiotics susceptibility pattern of Streptococcus pneumonia in Iran

“…In a study in Southeast Austria that was performed in 1997 to 2008, it was reported that resistance to erythromycin increased from 3.5% in 1997 to 14.7% in 2008. For trimethoprim/sulfamethoxazole, resistance increased slightly to 9.2% in 2008 (31). Moreover, in Nigeria a study reported an antimicrobial resistant profile of S. pneumoniae isolated from suspected tuberculosis patients.…”

Western Europe

“…The lowest rates of penicillin-resistant pneumococci are found in the Netherlands and Southeast Austria (,1%) [47,48]. Rates in Belgium are a little bit higher (4%) but in other regions can be much higher, up to 38% [49][50][51].…”

Streptococcus pneumoniae non-susceptibility and outpatient antimicrobial prescribing rates at the Alaska Native Medical Center

“…American Indian and Alaska Native (AI/AN) people have had some of the highest reported rates of invasive pneumococcal disease (IPD) in the world (4). Increasing antimicrobial resistance in this community-acquired pathogen has been an area of concern over the previous 2 decades (1,4–6). Early initiation of appropriate antibiotic therapy for IPD has been linked to improved outcomes (7).…”

“…Early initiation of appropriate antibiotic therapy for IPD has been linked to improved outcomes (7). Empiric antimicrobial therapy for IPD is typically chosen before sensitivities of the infecting organism are identified; thus, clinicians and healthcare practitioners need to know the S. pneumoniae antimicrobial resistance patterns for their region and the state in general (6). While data from Europe exist on the impact of changes in prescribing rates on non-susceptibility patterns of S. pneumoniae causing IPD, data from the same population over time have seldom been evaluated within the United States (3,8–15).…”