title: Antibiotic resistance in invasive Streptococcus pneumoniae isolates identified in Scotland between 1999 and 2007.
abstract: Data from 4727 invasive isolates of Streptococcus pneumoniae submitted to the Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory between 1999 and 2007 were analysed to establish susceptibility profiles to penicillin, erythromycin and cefotaxime. Pneumococcal resistance to penicillin over the study period remained low, with only 0.2 % (n=7/4727) of isolates falling into this category (MIC ≥2 mg l(-1)). These isolates have been sporadic, and have mainly represented serogroup 14 (ST9) and 9 (ST156). In comparison, the 'intermediate sensitivity' group (MIC 0.12-1 mg l(-1)) ranged between 2 and 6 % per year, the majority from serogroup 9 (ST156). Over the study period, we found that 12 % (n=585/4727) of isolates were erythromycin-resistant (MIC >0.5 mg l(-1)), with the majority (n=467; 80 %) of these isolates identified as serogroup 14 (ST9). Cephalosporin resistance (cefotaxime MIC >1 mg l(-1)) was found in only 0.06 % (n=2/3135) of isolates. Internationally recognized clones (Pneumococcal Molecular Epidemiology Network) accounted for 35 % (n=28/81) of the penicillin non-susceptible isolates and 75 % (n=248/330) of the macrolide-resistant isolates, with ST9 and ST306 predominating. Between 1999 and 2007 we found that 11.6 % (n=18/155) of the penicillin non-susceptible isolates and 4.8 % (n=28/585) of the macrolide-resistant isolates were from serogroups not covered by the 7-valent conjugate pneumococcal vaccine in use in the UK since 2006. Susceptibility to first-line antimicrobial agents for invasive pneumococcal disease in Scotland remained high over the period 1999-2007.
authors.affiliation: Microbiology Department, Glasgow Royal Infirmary, Glasgow, UK.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Cooke
authors.affiliation: Infection and Immunity Research Group, Glasgow Dental School, Faculty of Medicine, University of Glasgow, Glasgow, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Smith
authors.affiliation: Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory, Stobhill Hospital, Glasgow, UK.
authors.forename: Mathew
authors.initials: M
authors.lastname: Diggle
authors.affiliation: Department of Statistics and Modelling Science, University of Strathclyde, Glasgow, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Lamb
authors.affiliation: Department of Statistics and Modelling Science, University of Strathclyde, Glasgow, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Robertson
authors.affiliation: Department of Microbiology, Monklands Hospital, Airdrie, UK.
authors.forename: Donald
authors.initials: D
authors.lastname: Inverarity
authors.affiliation: Molecular Microbiology Group, Division of Infection, Inflammation & Immunity, University of Southampton, School of Medicine, Southampton, UK.
authors.forename: Johanna
authors.initials: J
authors.lastname: Jefferies
authors.affiliation: Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory, Stobhill Hospital, Glasgow, UK.
authors.forename: Giles
authors.initials: G
authors.lastname: Edwards
authors.affiliation: Glasgow Biomedical Research Centre, University of Glasgow, Glasgow, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Mitchell
authors.affiliation: Molecular Microbiology Group, Division of Infection, Inflammation & Immunity, University of Southampton, School of Medicine, Southampton, UK.
authors.forename: Stuart
authors.initials: S
authors.lastname: Clarke
authors.affiliation: Health Protection Scotland, Glasgow, UK.
authors.forename: Jim
authors.initials: J
authors.lastname: McMenamin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000382:microbiology*; D012606:Scotland; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents