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Antimicrobial Agents and Chemotherapy, April 2001, p. 1037-1042, Vol. 45, No. 4
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.4.1037-1042.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Need for Annual Surveillance of Antimicrobial Resistance in Streptococcus pneumoniae in the United States: 2-Year Longitudinal Analysis

Daniel F. Sahm,1,* James A. Karlowsky,1 Laurie J. Kelly,1 Ian A. Critchley,1 Mark E. Jones,2 Clyde Thornsberry,3 Yolanda Mauriz,4 and James Kahn4

MRL, Herndon, Virginia,1 Utrecht, The Netherlands,2 and Brentwood, Tennessee,3 and Ortho-McNeil Pharmaceutical, Raritan, New Jersey4

Received 24 May 2000/Returned for modification 26 August 2000/Accepted 17 January 2001

Although changing patterns in antimicrobial resistance in Streptococcus pneumoniae have prompted several surveillance initiatives in recent years, the frequency with which these studies are needed has not been addressed. To approach this issue, the extent to which resistance patterns change over a 1-year period was examined. In this study we analyzed S. pneumoniae antimicrobial susceptibility results produced in our laboratory with isolates obtained over 2 consecutive years (1997-1998 and 1998-1999) from the same 96 institutions distributed throughout the United States. Comparison of results revealed increases in resistant percentages for all antimicrobial agents studied except vancomycin. For four of the agents tested (penicillin, cefuroxime, trimethoprim-sulfamethoxazole, and levofloxacin), the increases were statistically significant (P < 0.05). Resistance to the fluoroquinolone remained low in both years (0.1 and 0.6%, respectively); in contrast, resistance to macrolides was consistently greater than 20%, and resistance to trimethoprim-sulfamethoxazole increased from 13.3 to 27.3%. Multidrug resistance, concurrent resistance to three or more antimicrobials of different chemical classes, also increased significantly between years, from 5.9 to 11%. The most prevalent phenotype was resistance to penicillin, azithromycin (representative macrolide), and trimethoprim-sulfamethoxazole. Multidrug-resistant phenotypes that included fluoroquinolone resistance were uncommon; however, two phenotypes that included fluoroquinolone resistance not found in 1997-1998 were encountered in 1998-1999. This longitudinal surveillance study of resistance in S. pneumoniae revealed that significant changes do occur in just a single year and supports the need for surveillance at least on an annual basis, if not continuously.

* Corresponding author. Mailing address: MRL, 13665 Dulles Technology Dr., Suite 200, Herndon, VA 20171-4603. Phone: (703) 480-2500. Fax: (703) 480-2670. E-mail: dsahm{at}thetsn.com.

Antimicrobial Agents and Chemotherapy, April 2001, p. 1037-1042, Vol. 45, No. 4
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.4.1037-1042.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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