Penicillin-resistant Streptococcus pneumoniae in Lebanon: the first nationwide study.
A total of 123 clinical isolates of Streptococcus pneumoniae were collected from all over Lebanon and tested for their susceptibility to penicillin: 30.1% were susceptible (minimum inhibitory concentration (MIC) < or = 0.06 microg/mL), 56.1% were intermediately susceptible (MIC 0.09-1.0 microg/mL) and 13.8% were resistant (MIC > 1.0 microg/mL). The oxacillin disk screening test detected all penicillin-resistant isolates, but erroneously designated two penicillin-intermediate isolates as penicillin susceptible. All isolates were consistently susceptible to levofloxacin, but cross-resistance between penicillin and the three tested cephalosporins was frequently noted. The in vitro activity of amoxicillin/clavulanic acid paralleled that of penicillin; however, 92.7% of the isolates were designated as susceptible based on the recommended interpretive cut-off point (MIC < or = 2/1 microg/mL). This discrepancy represents a paradox that deserves serious consideration.
Uwaydah
Marwan
M
American University of Beirut Medical Center, P.O. Box 11 - 0236, Riad El Solh 110 72020, Beirut, Lebanon. mardah@cyberia.net.lb
Mokhbat
Jacques E
JE
Karam-Sarkis
Dolla
D
Baroud-Nassif
Rita
R
Rohban
Thomas
T
D007861:Lebanon; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects*
D010406:Penicillins