The epidemiology of respiratory tract pathogens in southern Netherlands

Results of sputum cultures and susceptibility tests have been reviewed for the years 1977-1986, with approximately 1,700 positive cultures per year. Haemophilus influenzae always occupied the first place, being grown in 65% of positive specimens in 1977 and 37% in 1986. Streptococcus pneumoniae occupied the second place, rising from 17 to 27% in the same period, during which Branhamella catarrhalis rose from 5 to 26%. Based on the frequency of occurrence of individual bacterial species in the sputum cultures and on the percentage of strains resistant to ampicillin, cotrimoxazole, doxycycline, erythromycin and ofloxacin, theoretical chances of failure of blind therapy were calculated and found to be most advantageous for ofloxacin and cotrimoxazole. No explanation could be given for the increase in beta-lactamase production by B. catarrhalis, but the disappearance of Haemophilus parainfluenzae may have been due to improvements in the identification procedure.