Aggregated antibiograms and monitoring of drug-resistant Streptococcus pneumoniae.
Community-specific antimicrobial susceptibility data may help monitor trends among drug-resistant Streptococcus pneumoniae and guide empiric therapy. Because active, population-based surveillance for invasive pneumococcal disease is accurate but resource intensive, we compared the proportion of penicillin-nonsusceptible isolates obtained from existing antibiograms, a less expensive system, to that obtained from 1 year of active surveillance for Georgia, Tennessee, California, Minnesota, Oregon, Maryland, Connecticut, and New York. For all sites, proportions of penicillin-nonsusceptible isolates from antibiograms were within 10 percentage points (median 3.65) of those from invasive-only isolates obtained through active surveillance. Only 23% of antibiograms distinguished between isolates intermediate and resistant to penicillin; 63% and 57% included susceptibility results for erythromycin and extended-spectrum cephalosporins, respectively. Aggregating existing hospital antibiograms is a simple and relatively accurate way to estimate local prevalence of penicillin-nonsusceptible pneumococcus; however, antibiograms offer limited data on isolates with intermediate and high-level penicillin resistance and isolates resistant to other agents.
D019411:Clinical Laboratory Techniques; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000188:drug therapy; D011159:Population Surveillance / Q000379:methods*; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D014481:United States