“…Spain was subsequently identified as an area with a high prevalence of antimicrobial agent-resistant pneumococci (80). Strains resistant to penicillin, tetracycline, and chloramphenicol were isolated from two patients in Britain late in 1981 (276); multiply resistant pneumococci, including erythromycin and TMP7SMZ resistance, were found in a carrier (86) and have more recently been isolated from the eye of a neonate in Great Britain (213). A serogroup 23 penicillin-, tetracycline-, and chloramphenicol-resistant pneumococcus was recovered in 1988 from six hospitalized patients in Newcastle (88) and four patients in Bristol (191), United Kingdom, and multiply resistant strains have been reported to the Central Public Health Laboratory from 14 of 15 health regions in England and Wales and from Scotland and Ireland (85).…”