The evolving threat of antibiotic resistance in Europe: new data from the Alexander Project

The Alexander project was established in 1992 to examine the antimicrobial susceptibility of community-acquired lower respiratory tract bacterial path ogens to a range of compounds, Since then it has expanded both geographical ly and in the number of antimicrobial agents tested. Within Europe, the mos t recent data have confirmed that the prevalence of penicillin resistance a mong isolates of Streptococcus pneumoniae is high in France and Spain, with both intermediate (MIC 0.12-1 mg/L) and resistant (MIC greater than or equ al to 2 mg/L) phenotypes, and combined resistance rates of >50%. Macrolide resistance is increasing generally both among penicillin-resistant and peni cillin-susceptible isolates of S. pneumoniae and its prevalence now exceeds that of penicillin resistance, overall (16.5% and 10.4%, respectively, in 1996; 21.9% and 14.1% in 1997; 16.5% and 11.6% in 1998). beta-Lactamase pro duction was the principal mechanism of resistance observed among isolates o f Haemophilus influenzae and Moraxella catarrhalis.