[Antibiotic resistance in 622 Streptococcus pneumoniae isolated from blood and cerebrospinal fluid in 33 Spanish hospitals participating in the European Antimicrobial Resistance Surveillance System (2000)].

INTRODUCTION

In 1998 the European Union founded the European Antimicrobial Resistance Surveillance System (EARSS) for the control of antimicrobial resistance in invasive pathogens. This report present the results obtained for S. pneumoniae in the year 2000 in Spain.

METHODS

Participants included 33 hospitals covering approximately 25% of the Spanish population. The laboratories carried out isolation, identification and sensitivity studies with their usual methods. Quality control was performed by the UK National External Quality Assurance Scheme (NEQAS). A form was filled out with clinical information on the patient and data on the hospital, department and specimen isolated. This information was entered in a central database for analysis and validation by the Whonet.5 program.

RESULTS

Invasive S. pneumoniae was isolated in 622 patients. Overall incidence was 6.4 cases/100,000 inhabitants. Among the strains isolated, 33.1% (CI 95%: 29.6-37) showed resistance to penicillin (22.2% intermediate; 10.9% resistant); 11% showed resistance to cefotaxime (10.1% intermediate; 0.9% resistant); and 21.1% were resistant to erythromycin. Erythromycin resistance was 7% in penicillin-sensitive strains and 46.4% in penicillin-resistant strains (p < 0.001). A total of 51.7% of strains were resistant to penicillin in children < or = 4 years old, as compared to 29% in patients > 4 years old (p < 0.001). A ciprofloxacin MIC > 2 mg/L was found for 2.4% of isolates.

CONCLUSIONS

Penicillin resistance in invasive S. pneumoniae in Spain is among the highest in the European Union. The decrease in sensitivity to penicillin was significantly associated with cefotaxime and erythromycin resistance. Children < or = 4 years old have a significantly higher risk than adults of acquiring infection with strains resistant to penicillin, cefotaxime and erythromycin.