Prevalence of antimicrobial resistance of Streptococcus pneumoniae in southwest Germany as determined by the E test

Antimicrobial susceptibilities and serotypes of invasive Streptococcus pneumoniae strains in Switzerland

In 1993 and 1994, 10 microbiological laboratories in Switzerland collected 351 strains of Streptococcus pneumoniae from invasive infections. Susceptibilities to the main representatives of the chemical classes were as follows: penicillin, 93%; chloramphenicol, 92%; erythromycin, 94%; sulfamethoxazole-trimethoprim, 86%; tetracycline, 92%; vancomycin, 100%. Forty-three strains showed resistance to one agent, and 35 strains showed resistance to two or more antimicrobial agents simultaneously; i.e., 22% of the strains were resistant to at least one antimicrobial agent. Four strains (1%) were fully resistant to penicillin, whereas 21 strains (6%) showed reduced susceptibility. Of these 25 strains not fully susceptible to penicillin, 10 were resistant to one, 3 were resistant to two, and 8 were resistant to three additional antimicrobial agents. Of the quinolones, sparfloxacin was the most active substance, with an MIC at which 90% of the strains are inhibited of 0.5 mg/liter. The most common serotypes were types 6 (13.6% of isolates), 7 (10.5%), 19 (10.5%), 14 (9.1%), and 1 (8.5%) as well as 3 and 23 (8.0% each). Reduced susceptibility to penicillin was found mainly among serotypes 6, 14, 19, and 23. The currently available 23-valent pneumococcal vaccine covers 320 (91%) of the pneumococci isolated. Regional differences within Switzerland with regard to serotypes and antimicrobial resistance were not observed.