Invasive Streptococcus pneumoniae infections: serotype distribution and antimicrobial resistance in Canada, 1992-1995.
OBJECTIVE
To report current information about invasive pneumococcal infections, capsular types and antimicrobial resistance in Canada.


METHODS
Retrospective analysis.


METHODS
Canada.


METHODS
A total of 976 patients from whom Streptococcus pneumoniae was isolated from blood or cerebrospinal fluid between Jan. 1, 1992, and Dec. 31, 1995.


METHODS
Capsular type and antimicrobial susceptibility.


RESULTS
Twenty types accounted for 90.8% of the isolates from patients over 5 years of age; all but type 15A are covered by the currently available 23-valent vaccine. Nine types accounted for 92% of the isolates recovered from children 5 years and less. Reduced susceptibility to penicillin was found in 7.8% of the collection and was associated with types 6B, 9V and 19A. Full resistance to penicillin was observed most frequently during 1995 and was associated with type 9V. Rates of reduced susceptibility over one 12-month period were 19.5% for trimethoprim-sulfamethoxazole and 4.5% or less for each of cefotaxime, ceftriaxone, chloramphenicol, erythromycin, ofloxacin and tetracycline.


CONCLUSIONS
Over 90% of invasive pneumococcal infections are covered by the currently available vaccines (for people over 2 years of age) and the pneumococcal protein-polysaccharide conjugate vaccines under development for young children. The high frequency of antimicrobial resistance observed requires more complete investigation and confirmation; however, taken from a global perspective, it supports the need to develop better control strategies, including greater use of new and existing vaccines.
Lovgren
M
M
National Centre for Streptococcus, Provincial Laboratory of Public Health, Northern Alberta, Edmonton. ml@bugs.uah.ualberta.ca
Spika
J S
JS
Talbot
J A
JA
D000328:Adult; D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial / Q000032:analysis*; D002170:Canada / Q000453:epidemiology; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D006801:Humans; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D012189:Retrospective Studies; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000276:immunology / Q000472:pathogenicity
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial