ANTIBIOTIC SUSCEPTIBILITY PATTERNS OF STREPTOCOCCUS-PNEUMONIAE IN CHINA AND COMPARISON OF MICS BY AGAR DILUTION AND E-TEST METHODS

Beta-lactam resistance by Streptococcus pneumoniae is becoming a signi ficant threat to public health worldwide, However, data concerning ant ibiotic susceptibility patterns in China have not been published. In t his study, a total of 79 clinical isolates and 244 nasopharyngeal isol ates of S, pneumoniae were recovered between June and November 1997 in Beijing, The agreement between the MICs (+/-1 log(2) dilution) of pen icillin and ceftriaxone obtained by the agar dilution and E-test metho ds for the 79 clinical strains was very good (97.5 and 93.7%, respecti vely), Of these 79 strains, 9, (11.4%) were intermediate and 2 (2.5%) were resistant to penicillin. Of the 244 nasopharyngeal strains, 32 (1 3.1%) were intermediate and 3 (1.2%) were resistant to penicillin. The total of 277 penicillin-susceptible clinical and nasopharyngeal isola tes of Streptococcus pneumoniae were 100% susceptible to amoxicillin-c lavulanic acid, cefuroxime, ceftriaxone, and cefotaxime. In the 35 pen icillin-intermediate and -resistant nasopharyngeal strains, elevated M ICs of amoxicillin-clavulanic acid: cefuroxime, ceftriaxone, and cefot axime were seen for less than or equal to 4 isolates. Of 244 nasophary ngeal isolates, the overall percentages of tetracycline, erythromycin, chloramphenicol, ofloxacin, and trimethoprim-sulfamethoxazole resista nce were 87.6, 74.0, 47.8, 3.7 and 63.3, respectively. Vancomycin and rifampin resistance were not detected. These findings demonstrate that the rate of penicillin-resistant pneumococci is relatively low in Chi na compared to those of other Asian countries. Resistance to non-beta- lactams was much higher than to beta-lactams. The E-test and agar dilu tion methods appeared to be comparable in identifying resistant strain s.