title: The activity of levofloxacin and comparator agents against clinical isolates of Streptococcus pneumoniae collected worldwide during 1999 and 2000.
abstract: BACKGROUND
  Increases in penicillin-resistant Streptococcus pneumoniae have been documented worldwide.
  
  
  METHODS
  During 1999 and 2000, 5,015 S. pneumoniae isolates were collected from 13 countries on five continents and tested for antimicrobial susceptibility.
  
  
  RESULTS
  Penicillin resistance rates were as follows: South Korea, 70.1%; Hong Kong, 50.3%; Thailand, 39.3%; France, 28.7%; Spain, 24.8%; Mexico, 18.1%; Ireland, 11.8%; South Africa, 11.1%; Italy, 9.4%; United Kingdom, 3.1%; Brazil, 2.9%; China, 2.3%, and Germany, 0.7%. Resistance to azithromycin, clarithromycin and trimethoprim-sulfamethoxazole was commonly associated with penicillin resistance. Levofloxacin-resistant isolates were detected in 8 of 13 countries: Germany (0.2%), France (0.4%), Thailand (0.5%), South Korea (0.9%), Mexico (1.5%), Spain (1.6%), China (3.3%) and Hong Kong (8.0%). Multidrug resistance (resistance to >/=3 antimicrobial classes) occurred in 626/5,015 isolates (12.5%). Levofloxacin was active against 96.0% (601/626) of the multidrug-resistant (MDR) isolates and 99.7% (4,374/4,389) of the non-MDR isolates.
  
  
  CONCLUSIONS
  Although relatively high levels of levofloxacin resistance were detected in China and Hong Kong, overall, levofloxacin remained active against >99% of clinical isolates of S. pneumoniae despite their resistance to other agents. Continued surveillance of S. pneumoniae will track any changes in levofloxacin activity, should they occur.
authors.affiliation: Focus Technologies Inc., Hilversum, The Netherlands. mjones@focusanswers.com
authors.forename: Mark E
authors.initials: ME
authors.lastname: Jones
authors.forename: Renee S
authors.initials: RS
authors.lastname: Blosser-Middleton
authors.forename: Ian A
authors.initials: IA
authors.lastname: Critchley
authors.forename: Clyde
authors.initials: C
authors.lastname: Thornsberry
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Sahm
authors.forename: Juri
authors.initials: J
authors.lastname: Yamakita
authors.forename: Moriaki
authors.initials: M
authors.lastname: Akasaki
authors.forename: James A
authors.initials: JA
authors.lastname: Karlowsky
mesh_terms: D000349:Africa / Q000453:epidemiology; D000569:Americas / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001208:Asia / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D024881:Drug Resistance, Bacterial; D005060:Europe / Q000453:epidemiology; D006801:Humans; D064704:Levofloxacin; D008826:Microbial Sensitivity Tests; D015242:Ofloxacin / Q000494:pharmacology*; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D014640:Vancomycin; D015242:Ofloxacin