Increasing antibiotic resistance of streptococcus species in New York City.
OBJECTIVE
Streptococcus species are common pathogens in head and neck infections and are leading causes of morbidity and mortality. Emerging penicillin-resistant streptococcal pathogens have shifted empirical antibiotic therapy in favor of valuable alternatives, including erythromycin and clindamycin. This study was undertaken to determine the magnitude of antimicrobial resistance to these antibiotics.


METHODS
Retrospective review.


METHODS
A retrospective study of two streptococcal species isolates, Streptococcus pyogenes (163 specimens) and Streptococcus pneumoniae (164 specimens), collected between January 1, 2001 and January 1, 2002 at two academic institutions. The antibiotic susceptibility patterns were analyzed for penicillin, erythromycin, and clindamycin according to the National Committee for Clinical Laboratory Standards.


RESULTS
Fourteen percent to 34% of S. pyogenes isolates were erythromycin-resistant, and 0% to 28% were clindamycin-resistant. None of the S. pyogenes isolates were resistant to penicillin. Of the S. pneumoniae isolates, 33% to 50% were resistant to erythromycin, and 18% to 33% were resistant to clindamycin. The penicillin resistance levels for S. pneumoniae were 0% to 45%.


CONCLUSIONS
Our antimicrobial resistance levels for S. pyogenes and S. pneumoniae significantly exceeded national and worldwide levels of erythromycin and clindamycin resistance. With a diverse population of over 8 million residents and high physician supply, our model is a microcosm for the study of antimicrobial use and susceptibility patterns and of clinical failure.
Lin
Karen
K
Department of Otolaryngology, New York University Medical Center, New York, NY, USA.
Tierno
Philip M
PM
Komisar
Arnold
A
D002981:Clindamycin / Q000627:therapeutic use; D004351:Drug Resistance; D024881:Drug Resistance, Bacterial; D004917:Erythromycin / Q000627:therapeutic use; D006801:Humans; D008826:Microbial Sensitivity Tests; D009519:New York City / Q000453:epidemiology; D010403:Penicillin Resistance; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D013297:Streptococcus pyogenes / Q000187:drug effects*
D002981:Clindamycin; D004917:Erythromycin