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Antimicrobial Agents and Chemotherapy, September 2004, p. 3305-3311, Vol. 48, No. 9
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.9.3305-3311.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

In Vitro Antimicrobial Susceptibilities of Streptococcus pneumoniae Clinical Isolates Obtained in Canada in 2002

Jeff Powis,1,2 Allison McGeer,1,2 Karen Green,1 Otto Vanderkooi,1,2 Karl Weiss,3 George Zhanel,4 Tony Mazzulli,1,2 Magdalena Kuhn,5 Deirdre Church,5 Ross Davidson,6 Kevin Forward,6 Daryl Hoban,4 Andrew Simor,8 the Canadian Bacterial Surveillance Network,7,{dagger} and Donald E. Low1,2*

Department of Microbiology, Toronto Medical Laboratories and Mount Sinai Hospital,1 University of Toronto,2 Sunnybrook and Women's College Health Sciences Center, Toronto, Ontario,8 Hopital Maisonneuve-Rosemont, University of Montreal, Montreal, Quebec,3 Health Sciences Center, Winnipeg, Manitoba,4 Southeast Healthcare Corp.-Moncton Site, Moncton, New Brunswick,5 Calgary Laboratory Services, Calgary, Alberta,6 QEII Elizabeth Health Sciences Center, Halifax, Nova Scotia, Canada7

Received 23 February 2004/ Returned for modification 25 March 2004/ Accepted 26 April 2004

Empirical treatment is best guided by current surveillance of local resistance patterns. The goal of this study is to characterize the prevalence of antimicrobial nonsusceptibility within pneumococcal isolates from Canada. The Canadian Bacterial Surveillance Network is comprised of laboratories from across Canada. Laboratories collected a defined number of consecutive clinical and all sterile site isolates of S. pneumoniae in 2002. In vitro susceptibility testing was performed by broth microdilution with NCCLS guidelines. Rates of nonsusceptibility were compared to previously published reports from the same network. A total of 2,539 isolates were tested. Penicillin nonsusceptibility increased to 15% (8.5% intermediate, 6.5% resistant) compared to 12.4% in 2000 (P ≤ 0.025, {chi}2). Only 32 (1.3%) isolates had an amoxicillin MIC of ≥4 µg/ml and only 2 of 32 cerebrospinal fluid isolates had an intermediate susceptibility to ceftriaxone by meningeal interpretive criteria (MIC = 1 µg/ml). A total of 354 (13.9%) isolates were macrolide nonsusceptible (46.3% MLSB, 56.7% M phenotype), increasing from 11.4% in 2000 (P ≤ 0.0075, {chi}2). Only 13 (<1%) isolates had a telithromycin MIC of >1 µg/ml. Ciprofloxacin nonsusceptibility (defined as an MIC of ≥4 µg/ml) increased to 2.7% compared to 1.4% in 2000 (P ≤ 0.0025, {chi}2) and was primarily found in persons ≥18 years old (98.5%). Nonsusceptibility to penicillin, macrolides, and fluoroquinolones is increasing in Canada. Nonsusceptibility to amoxicillin and ceftriaxone remains uncommon. Newer antimicrobials such as telithromycin and respiratory fluoroquinolones have excellent in vitro activity.

* Corresponding author. Mailing address: Department of Microbiology, Rm. 1487, Mount Sinai Hospital, 600 University Ave., Toronto, M5G 1X5 Ontario, Canada. Phone: (416) 586-4435. Fax: (416) 586-8746. E-mail: dlow{at}mtsinai.on.ca.

{dagger} Contributing members of the Canadian Bacterial Surveillance Network are listed in Acknowledgments.

Antimicrobial Agents and Chemotherapy, September 2004, p. 3305-3311, Vol. 48, No. 9
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.9.3305-3311.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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