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Antimicrobial Agents and Chemotherapy, December 2001, p. 3334-3340, Vol. 45, No. 12
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.12.3334-3340.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Antimicrobial Susceptibilities of 1,684 Streptococcus pneumoniae and 2,039 Streptococcus pyogenes Isolates and Their Ecological Relationships: Results of a 1-Year (1998-1999) Multicenter Surveillance Study in Spain

E. Pérez-Trallero,1 C. Fernández-Mazarrasa,2 C. García-Rey,3 E. Bouza,4 L. Aguilar,3,* J. García-de-Lomas,5 F. Baquero,6 and The Spanish Surveillance Group for Respiratory Pathogensdagger

Microbiology Department, Hospital Donostia, San Sebastián,1 Microbiology Department, Residencia Marqués de Valdecilla, Santander,2 Medical Department, GlaxoSmithKline, Tres Cantos,3 Microbiology Department, Hospital General Universitario Gregorio Marañón,4 and Microbiology Department, Hospital Ramón y Cajal,6 Madrid, and Instituto Valenciano de Microbiología, Valencia,5 Spain

Received 27 September 2000/Returned for modification 30 April 2001/Accepted 26 July 2001

A nationwide multicenter susceptibility surveillance study which included 1,684 Streptococcus pneumoniae and 2,039 S. pyogenes isolates was carried out over 1 year in order to assess the current resistance patterns for the two most important gram-positive microorganisms responsible for community-acquired infections in Spain. Susceptibility testing was done by a broth microdilution method according to National Committee for Clinical Laboratory Standards M100-S10 interpretative criteria. For S. pneumoniae, the prevalences of highly resistant strains were 5% for amoxicillin and amoxicillin-clavulanic acid; 7% for cefotaxime; 22% for penicillin; 31% for cefuroxime; 35% for erythromycin, clarithromycin, and azithromycin; and 42% for cefaclor. For S. pyogenes, the prevalence of erythromycin resistance was 20%. Efflux was encountered in 90% of S. pyogenes and 5% of S. pneumoniae isolates that exhibited erythromycin resistance. Erythromycin resistance was associated with clarithromycin and azithromycin in both species, regardless of phenotype. Despite the different nature of the mechanisms of resistance, a positive correlation (r = 0.612) between the two species in the prevalence of erythromycin resistance was found in site-by-site comparisons, suggesting some kind of link with antibiotic consumption. Regarding ciprofloxacin, the MIC was >= 4 µg/ml for 7% of S. pneumoniae and 3.5% of S. pyogenes isolates. Ciprofloxacin resistance (MIC, >= 4 µg/ml) was significantly (P < 0.05) associated with macrolide resistance in both S. pyogenes and S. pneumoniae and with penicillin nonsusceptibility in S. pneumoniae.

* Corresponding author. Mailing address: Medical Department, GlaxoSmithKline, c/Doctor Severo Ochoa, 2, Parque Tecnologico de Madrid, 28760 Tres Cantos, Madrid, Spain. Phone: 34 91 807 5912. Fax: 34 91 807 0596. E-mail: lorenzo.aguilar-alfaro{at}gsk.com.

dagger The members of the Spanish Surveillance Group for Respiratory Pathogens are listed in the appendix.

Antimicrobial Agents and Chemotherapy, December 2001, p. 3334-3340, Vol. 45, No. 12
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.12.3334-3340.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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