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The incidence of penicillin-resistant pneumococci in the Slovak Republic. Pneumococcus Study Group
J Trupl1, H Hupková, P C Appelbaum
1Department of Clinical Microbiology, National Cancer Center, Bratislava, Slovakia.
Abstract:
The prevalence of penicillin-resistant Streptococcus pneumoniae and multiresistant strains isolated in Europe from the early 1970s has continued to rise. Twenty-four microbiology laboratories in the Slovak Republic analyzed 4,018 S. pneumoniae strains isolated from September 1, 1993, to December 31, 1993. The overall resistance rate to penicillin was 3.4% in strains isolated from outpatients and 8.5% from inpatients with considerable variation between regions. The highest regional resistance rate to penicillin was 21% from outpatients in Levice, in the western Slovakia, and ranged between 13 and 52% in strains collected from hospitalized patients in 6 regions. Rates of penicillin-resistant pneumococci were significantly higher (p < or = 0.01) in children aged < or = 3 years. Two thirds of penicillin-resistant strains had intermediate levels of resistance (MICs 0.1-1 microgram/ml) and one third was resistant (MICs 2-8 micrograms/ml). Resistance to multiple classes of agents was found in 75.9% of penicillin-resistant strains. These data support continued surveillance of antimicrobial resistance in pneumococcal infections. Standardization of susceptibility testing methods and monitoring of clinical outcomes is of critical importance to this complex problem.
Insights
Penicillin resistance in Streptococcus pneumoniae is rising in the Slovak Republic, particularly in young children and hospitalized patients. Surveillance of antimicrobial resistance is crucial for managing pneumococcal infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Penicillin-resistant Streptococcus pneumoniae strains have been increasing in Europe since the 1970s.
- Multiresistant bacterial strains pose a growing global health concern.
Purpose of the Study:
- To determine the prevalence and characteristics of penicillin-resistant Streptococcus pneumoniae in the Slovak Republic.
- To assess regional variations and patient demographics associated with pneumococcal resistance.
Main Methods:
- Analysis of 4,018 Streptococcus pneumoniae strains collected from September to December 1993.
- Microbiological susceptibility testing to penicillin and multiple antimicrobial agents.
- Statistical analysis to identify significant differences in resistance rates.
Main Results:
- Overall penicillin resistance was 3.4% in outpatients and 8.5% in inpatients.
- Highest regional resistance rates reached 21% (outpatients) and 52% (inpatients).
- Significantly higher resistance rates (p < 0.01) were observed in children under 3 years old.
- 75.9% of penicillin-resistant strains exhibited resistance to multiple antimicrobial classes.
Conclusions:
- Continued surveillance of antimicrobial resistance in Streptococcus pneumoniae is essential.
- Standardization of susceptibility testing and monitoring clinical outcomes are critical for addressing resistance.
- The study highlights the significant burden of antibiotic resistance in pneumococcal infections within the Slovak Republic.