New penicillin susceptibility breakpoints for Streptococcus pneumoniae and their effects on susceptibility categorisation in Germany (1992-2008).

Continuous nationwide surveillance of invasive pneumococcal disease (IPD) has been conducted in Germany. From 1992 to 2008, 12137IPD isolates were collected, including 2201 isolates (18.1%) from patients with meningitis and 9936 isolates (81.9%) from non-meningitis cases. Data on penicillin susceptibility were available for 11814 invasive isolates. Categorisation of penicillin susceptibility according to the former Clinical and Laboratory Standards Institute (CLSI) guidelines resulted in 4.3% intermediate and 1.2% resistant isolates. When the new CLSI 2008 guidelines are applied, considerably higher resistance rates are observed in the meningitis group (6.5% resistant) than among the non-meningitis cases (0.0% resistant, 0.3% intermediate).