title: Antimicrobial resistance of Streptococcus pneumoniae isolates of outpatients in Germany, 1999-2000.
abstract: BACKGROUND
  The aim of the study was to determine the prevalence of antimicrobial resistance among clinical isolates of Streptococcus pneumoniae during the winter of 1999-2000 in Germany.
  
  
  METHODS
  Pneumococcal isolates were prospectively collected by 14 different clinical microbiology laboratories. Minimal inhibitory concentrations of penicillin G, erythromycin A, clarithromycin, roxithromycin, azithromycin, clindamycin, levofloxacin and telithromycin were determined by the broth microdilution method.
  
  
  RESULTS
  Among 328 strains 4.6% were nonsusceptible to penicillin G (intermediate and resistant strains) and 9.5% were resistant to erythromycin A. Analysis of erythromycin-resistant strains for the underlying resistance determinants revealed that 12 (38.7%) belonged to the erm(B) and 19 (61.3%) to the mef(E) type of resistance. Among the macrolide-resistant strains, serotypes 19F (n = 9) and 14 (n = 8) were the predominant types.
  
  
  CONCLUSIONS
  Macrolide resistance in Germany is of growing concern and mainly due to the high prevalence of pneumococci expressing the mef(E) type of resistance.
authors.affiliation: Institute of Medical Microbiology, National Reference Center for Streptococci, University Hospital, Pauwelsstrasse 30, DE-52057 Aachen, Germany. reinert@rwth-aachen.de
authors.forename: Ralf René
authors.initials: RR
authors.lastname: Reinert
authors.forename: Rudolf
authors.initials: R
authors.lastname: Lütticken
authors.forename: Susanne
authors.initials: S
authors.lastname: Reinert
authors.forename: Adnan
authors.initials: A
authors.lastname: Al-Lahham
authors.forename: Sebastian
authors.initials: S
authors.lastname: Lemmen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000096:biosynthesis; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D005858:Germany; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D018942:Macrolides / Q000494:pharmacology*; D008297:Male; D008565:Membrane Proteins / Q000096:biosynthesis; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010045:Outpatients; D010403:Penicillin Resistance; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000472:pathogenicity*
chemical_list: D001426:Bacterial Proteins; D018942:Macrolides; C431304:MefE protein, Streptococcus pneumoniae; D008565:Membrane Proteins