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Journal of Clinical Microbiology, April 1999, p. 897-901, Vol. 37, No. 4
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Extremely High Incidence of Macrolide and Trimethoprim-Sulfamethoxazole Resistance among Clinical Isolates of Streptococcus pneumoniae in Taiwan

Po-Ren Hsueh,1,2 Lee-Jene Teng,3 Li-Na Lee,1,2 Pan-Chyr Yang,2 Shen-Wu Ho,3 and Kwen-Tay Luh1,2,*

Departments of Laboratory Medicine1 and Internal Medicine,2 National Taiwan University Hospital, and School of Medical Technology, National Taiwan University College of Medicine,3 Taipei, Taiwan

Received 15 September 1998/Returned for modification 1 November 1998/Accepted 21 December 1998

From January 1996 to December 1997, 200 isolates of Streptococcus pneumoniae recovered from 200 patients treated at National Taiwan University Hospital were serotyped and their susceptibilities to 16 antimicrobial agents were determined by the agar dilution method. Sixty-one percent of the isolates were nonsusceptible to penicillin, exhibiting either intermediate resistance (28%) or high-level resistance (33%). About two-fifths of the isolates displayed intermediate or high-level resistance to cefotaxime, ceftriaxone, cefepime, imipenem, and meropenem. Extremely high proportions of the isolates were resistant to erythromycin (82%), clarithromycin (90%), and trimethoprim-sulfamethoxazole (TMP-SMZ) (87%). Among the isolates nonsusceptible to penicillin, 23.8% were resistant to imipenem; more than 60% displayed resistance to cefotaxime, ceftriaxone, cefepime, and carbapenems; 96.7% were resistant to erythromycin; and 100% were resistant to TMP-SMZ. All isolates were susceptible to rifampin and vancomycin. The MICs at which 50% and 90% of the isolates were inhibited were 0.12 and 1 µg/ml, respectively, for cefpirome, and 0.12 and 0.25 µg/ml, respectively, for moxifloxacin. Six serogroups or serotypes (23F, 19F, 6B, 14, 3, and 9) accounted for 77.5% of all isolates. Overall, 92.5% of the isolates were included in the serogroups or serotypes represented in the 23-valent pneumococcal vaccine. The incidence of macrolide and TMP-SMZ resistance for S. pneumoniae isolates in Taiwan in this study is among the highest in the world published to date.

* Corresponding author. Mailing address: Department of Laboratory Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Rd., Taipei, Taiwan. Phone: 886-2-23562149. Fax: 886-2-23224263. E-mail: luhkt{at}ha.mc.ntu.edu.tw.

Journal of Clinical Microbiology, April 1999, p. 897-901, Vol. 37, No. 4
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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