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Emergence of macrolide and penicillin resistance among invasive pneumococcal isolates in Germany

Ralf René Reinert1, Adnan Al-Lahham, Maria Lemperle

  • 1Institute of Medical Microbiology, National Reference Center for Streptococci, University of Aachen, Pauwelsstrasse 30, D-52074 Aachen, Germany. reinert@rwth-aachen.de

The Journal of Antimicrobial Chemotherapy
|December 26, 2001
PubMed

Insights

Antibiotic resistance in invasive pneumococcal disease rose in Germany from 1992-2000. Erythromycin resistance significantly increased, correlating with macrolide antibiotic use.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Antibiotic resistance is a growing global health concern.
  • Invasive pneumococcal disease (IPD) requires effective antibiotic treatment.
  • Monitoring resistance patterns is crucial for public health.

Purpose of the Study:

  • To track nationwide antibiotic resistance trends in IPD in Germany.
  • To investigate the correlation between macrolide consumption and resistance.
  • To identify specific resistance mechanisms in resistant strains.

Main Methods:

  • Continuous nationwide surveillance of IPD strains in Germany (1992-2000).
  • Antimicrobial susceptibility testing for erythromycin, clindamycin, and penicillin.
  • Molecular typing of erythromycin-resistant isolates (erm(B) and mef genes).
  • Correlation analysis with macrolide consumption data.

Main Results:

  • Overall resistance rates: Erythromycin (7.7%), Clindamycin (3.5%).
  • Penicillin intermediate resistance: 3.3% average, increasing from 1.8% to 5.8%.
  • Erythromycin resistance dramatically increased from 3.0% to 15.3%.
  • Erythromycin resistance linked to erm(B) (43.4%) and mef (56.1%) genes.
  • Erythromycin resistance strongly correlated with newer macrolide consumption (r=0.89, P<0.01).

Conclusions:

  • Significant increase in macrolide and penicillin resistance in IPD strains in Germany.
  • Macrolide consumption is a key driver of erythromycin resistance.
  • Ongoing surveillance and prudent antibiotic use are essential.

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