Antimicrobial Resistance among Community-Acquired
Pneumonia Isolates in Europe: First Results from the
SENTRY Antimicrobial Surveillance Program 1997
Ad C. Fluit, PhD; Franz-Josef Schmitz, MD; Mark E.
Jones, PhD; Jacques Acar, MD; Renu Gupta, MD; Jan
Verhoef, MD; and the SENTRY Participants Group
Int J Infect Dis 1999; 3: 153-156.
Objective: The SENTRY antimicrobial surveillance program
was established to monitor the occurrence and antimicrobial
susceptibility of bacterial pathogens via an international
network of sentinel hospitals. Material and Methods:
Microorganisms were forwarded to the reference laboratory
for testing against various antimicrobial agents using broth
microdilution. Twenty European hospitals referred 286
Streptococcus pneumoniae, 309 Haemophilus influenzae,
and 167 Moraxella catarrhalis isolates during the first 10
months of the study, starting in April 1997. Results: Seven
percent of the S. pneumoniae isolates were highly resistant
to penicillin, and 21% showed intermediate resistance. The
highly resistant pneumococcal isolates came from Coimbra,
Barcelona, Athens, and London, whereas the intermediate
penicillin-resistant isolates were received from all
participating countries. The incidence of intermediate
penicillin-resistant pneumococci was lowest in Lausanne,
Freiburg and Duesseldorf, London, and Utrecht and highest
in southern European countries. Fifty-five percent of the
penicillin-resistant S. pneumoniae were also resistant to
erythromycin, and 35% to clindamycin. Sparfloxacin,
trovafloxacin, levofloxacin, and vancomycin were fully active
against pneumococcal isolates. Haemophilus influenzae
isolates were generally highly susceptible to most of the
antibiotics tested, and 92% of the M. catarrhalis isolates
were resistant to penicillin. Susceptibility to cephalosporins,
ciprofloxacin, levofloxacin, and rifampicin was 100%.
Conclusion: Penicillin may no longer be the first-choice
drug for empirical treatment of pneumococcal infections.
The newer fluoroquinolones may play a role in the empirical
treatment of community-acquired pneumonia.
KEYWORDS: antibiotic, resistance, surveillance
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