ANTIBIOTIC-RESISTANCE OF PNEUMOCOCCI IN NORWAY

A collection of 178 pneumococcal isolates found in Norway during the p eriod 1987-1994 were tested for their susceptibility to benzylpenicill in, macrolides (azithromycin, clarithromycin, dirithromycin, erythromy cin, roxithromycin, spiramycin), fluoroquinolones (ciprofloxacin, spar floxacin), imipenem, chloramphenicol, and vancomycin by a standard aga r dilution procedure. To benzylpenicillin, two strains (1%) showed res istance and 14 strains (8%) intermediate susceptibility. Towards eryth romycin, eight strains (4%) showed resistance and four strains (2%) in termediate susceptibility. Cross-resistance was demonstrated among the macrolides. Among the fluoroquinolones, intermediate susceptibility o ccurred with 42% of the isolates for sparfioxacin and 90% for ciproflo xacin; to the latter 5.1% proved resistant. The sum of intermediate an d highly resistant isolates was 53% for chloramphenicol. Both penicill in-resistant strains were isolated during the last 2 years of collecti on and came from patients of non-Norwegian ethnic background. Imported strains appeared over represented among the strains resistant to peni cillin and macrolides. Only imipenem and vancomycin showed full suscep tibility for all pneumococci tested. An over representation of serogro up 6 strains was apparent among the strains with intermediate suscepti bility and high resistance to benzylpenicillin. It is apparent that hi gh-level resistance has, not so far, become a difficult problem in Nor way. Nevertheless, the situation requires monitoring of the resistance level, particularly in meningitis and septic patients, and certainly in patients who entail a higher than usual possibility of acquiring pn eumococci from pools of resistant strains outside Norway (visitors, im migrants and recent returnees from abroad). (C) 1998 Elsevier Science B.V./International Society of Chemotherapy. All rights reserved.