title: Emergence of macrolide and penicillin resistance among invasive pneumococcal isolates in Germany.
abstract: Continuous nationwide surveillance of antibiotic resistance in invasive pneumococcal disease was performed in Germany between 1992 and 2000, with a total of 2586 strains being isolated. The average resistance rates to erythromycin and clindamycin were 7.7% and 3.5%, respectively, throughout the study period; 3.3% of strains were found to have intermediate resistance to penicillin. Over the study period an increase in both macrolide and penicillin resistance was observed. The percentage of strains exhibiting reduced susceptibility to penicillin increased from 1.8% in 1992 to 5.8% in 2000. A dramatic increase in resistance was observed with erythromycin, where the resistance rate rose from 3.0% in 1992 to 15.3% in 2000. Of the erythromycin-resistant strains, 86 (43.4%) and 111 (56.1%) belonged to the erm(B) and mef types of resistance, respectively. An analysis of macrolide consumption data during the study period showed that erythromycin resistance was highly correlated to the consumption of newer bd and od macrolides (r = 0.89, P < 0.01).
authors.affiliation: Institute of Medical Microbiology, National Reference Center for Streptococci, University of Aachen, Pauwelsstrasse 30, D-52074 Aachen, Germany. reinert@rwth-aachen.de
authors.forename: Ralf René
authors.initials: RR
authors.lastname: Reinert
authors.forename: Adnan
authors.initials: A
authors.lastname: Al-Lahham
authors.forename: Maria
authors.initials: M
authors.lastname: Lemperle
authors.forename: Christoph
authors.initials: C
authors.lastname: Tenholte
authors.forename: Claudia
authors.initials: C
authors.lastname: Briefs
authors.forename: Stefan
authors.initials: S
authors.lastname: Haupts
authors.forename: Hans Hubert
authors.initials: HH
authors.lastname: Gerards
authors.forename: Rudolf
authors.initials: R
authors.lastname: Lütticken
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D024881:Drug Resistance, Bacterial / Q000502:physiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D018942:Macrolides; D008297:Male; D008875:Middle Aged; D010403:Penicillin Resistance / Q000502:physiology; D010406:Penicillins / Q000494:pharmacology; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides; D010406:Penicillins