Pneumococcus observatory data collected in the Rhone-Alpes region of France in 1996.

Throughout 1996, 22 hospital-based laboratories in the Rhone-Alpes region o f France collected pneumococcal strains and used a standardized protocol to record the following data; patient age and sex; type of specimen; and dete rmination of susceptibility to at least the following antibiotics: oxacilli n 1 mu g and 5 mu g, erythromycin (Ery), tetracycline (Tet), chloramphenico l (Chl), rifampin (Rmp), and loracarbef. For penicillin-nonsusceptible stra ins (PNSSs), which were identified based on results with oxacillin, MICs fo r penicillin G, amoxicillin (Amx), and cefotaxime (Ctx) were determined usi ng the E Test(R), at the study site and agar dilution at the coordinating c enter. Of the 1153 strains, 65.5 % were from adults and 31.8% from children ; patient age was unknown in 2.7 % of cases. PNSPs (MIC > 0.06 mg/l) contri buted 32.9 % of strains (I: 23.3 %; R: 9.6 %) and were more common in child ren (41.1 %) than in adults (28.1 %). The frequency of PNSSs varied across specimen types : 27.9% in blood cultures (305 strains), 15.6% in cerebrospi nal fluid (32), 38.7 % in protected bronchopulmonary specimens (31), 31.5 % in unprotected bronchopulmonary specimens (434), 50.8% in acute otitis med ia (118), and 34.4% in other specimens (221). Among PNSSs, nonsusceptibilit y (I + R) to other antibiotics was variable: fry, 62.1%; Tet, 41.5 %; Chi, 40.4 %; Rmp, 1.1 %. Corresponding figures for the overall strain population were fry, 33.3 %; Tet, 22.7 %; Chi, 22.8 %; Rmp, 0.9 %. In addition, 56.5 % of PNSSs exhibited multiple drug resistance. Resistance to amoxicillin (M IC > 2 mg/l) was demonstrated for only 5 strains. No strains were resistant to loracarbef or cefotaxime. Serotypes of the 379 PNSSs were as follows: 2 3F, 26.6 %; 14 (25.6 %); sv (18.2 %), 6 (8.7 %), 15 (5 %), 19 (4.5 %).