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Antimicrobial Agents and Chemotherapy, June 2003, p. 1867-1874, Vol. 47, No. 6
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.6.1867-1874.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Antimicrobial Resistance in Respiratory Tract Streptococcus pneumoniae Isolates: Results of the Canadian Respiratory Organism Susceptibility Study, 1997 to 2002

George G. Zhanel,1,2,3 Lorraine Palatnick,3 Kimberly A. Nichol,1,3 Tracy Bellyou,3 Don E. Low,4 and Daryl J. Hoban1,3*

Department of Medical Microbiology, Faculty of Medicine, University of Manitoba,1 Departments of Medicine,2 Clinical Microbiology, Health Sciences Centre, Winnipeg, Manitoba,3 Mount Sinai Hospital, Toronto, Ontario, Canada4

Received 6 September 2002/ Returned for modification 23 January 2003/ Accepted 26 February 2003

A total of 6,991 unique patient isolates of Streptococcus pneumoniae were collected from October 1997 to June 2002 from 25 medical centers in 9 of the 10 Canadian provinces. Among these isolates, 20.2% were penicillin nonsusceptible, with 14.6% being penicillin intermediate (MIC, 0.12 to 1 µg/ml) and 5.6% being penicillin resistant (MIC, ≥2 µg/ml). The proportion of high-level penicillin-resistant S. pneumoniae isolates increased from 2.4 to 13.8% over the last 3 years of the study, and the proportion of multidrug-resistant S. pneumoniae isolates increased from 2.7 to 8.8% over the 5-year period. Resistant rates (intermediate and resistant) among non-ß-lactam agents were as follows: macrolides, 9.6 to 9.9%; clindamycin, 3.8%; doxycycline, 5.5%; chloramphenicol, 3.9%; and trimethoprim-sulfamethoxazole, 19.0%. Rates of resistance to non-ß-lactam agents were higher among penicillin-resistant strains than among penicillin-susceptible strains. No resistance to vancomycin or linezolid was observed; however, 0.1% intermediate resistance to quinupristin-dalfopristin was observed. The rate of macrolide resistance (intermediate and resistant) increased from 7.9 to 11.1% over the 5 years. For the fluoroquinolones, the order of activity based on the MICs at which 50% of isolates are inhibited (MIC50s) and the MIC90s was gemifloxacin > clinafloxacin > trovafloxacin > moxifloxacin > grepafloxacin > gatifloxacin > levofloxacin > ciprofloxacin. The investigational compounds ABT-773 (MIC90, 0.008 µg/ml), ABT-492 (MIC90, 0.015 µg/ml), GAR-936 (tigecycline; MIC90, 0.06 µg/ml), and BMS284756 (garenoxacin; MIC90, 0.06 µg/ml) displayed excellent activities. Despite decreases in the rates of antibiotic consumption in Canada over the 5-year period, the rates of both high-level penicillin-resistant and multidrug-resistant S. pneumoniae isolates are increasing in Canada.

* Corresponding author. Mailing address: Clinical Microbiology, Health Sciences Centre, MS673-820 Sherbrook St., Winnipeg, Manitoba R3A 1R9, Canada. Phone: (204) 787-1191. Fax: (204) 787-4699. E-mail: dhoban{at}hsc.mb.ca.

Antimicrobial Agents and Chemotherapy, June 2003, p. 1867-1874, Vol. 47, No. 6
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.6.1867-1874.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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