title: Statewide sentinel surveillance for antibiotic nonsusceptibility among streptococcus pneumoniae isolates in South Carolina, 2003-2004.
abstract: BACKGROUND
  In 2003, the South Carolina Department of Health and Environmental Control established the Carolina Antibiotic Resistance Surveillance System (CARSS), an active sentinel surveillance system for antibiotic-resistant Streptococcus pneumoniae.
  
  
  METHODS
  CARSS includes twelve hospitals. Each hospital was assigned a weighted sample size. Minimum inhibitory concentrations were determined using the E-test method.
  
  
  RESULTS
  A total of 452 isolates were collected. The prevalence of penicillin nonsusceptibility in the study was 44.9%. Penicillin intermediate resistance (PCN-I) was 33.2%, and penicillin high-level resistance (PCN-R) was 11.7%. One hundred six (23.5%) isolates were nonsusceptible to one antibiotic. One hundred twenty-four (27.4%) isolates were nonsusceptible to three or more antibiotics.
  
  
  CONCLUSIONS
  CARSS confirmed the prevalences of antibiotic nonsusceptibility previously reported for South Carolina. However, CARSS suggests resistance is shifting from PCN-R to PCN-I in South Carolina. There is a high prevalence of multidrug nonsusceptibility in South Carolina. CARSS will continue to monitor these trends.
authors.affiliation: College of Pharmacy, University of South Carolina, USA. dgdauner7@yahoo.com
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Dauner
authors.forename: Dixie F
authors.initials: DF
authors.lastname: Roberts
authors.forename: George S
authors.initials: GS
authors.lastname: Kotchmar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D018571:Sentinel Surveillance; D013022:South Carolina / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
chemical_list: D000890:Anti-Infective Agents