Streptococcus pneumoniae: current aspects of antibiotic resistance

A worldwide issue: Streptococcus pneumoniae is an important pathogen implic ated in many illnesses. The susceptibility of this bacteria has greatly cha nged since 1967 when it was the leading strain resistant to penicillin C. S ince that rime, the resistance of S. pneumoniae has become a worldwide prob lem leading to the development of schemes to monitor resistance in differen t countries. The analysis of these "observation" studies points out the wid e variability of resistance to antibiotics depending on the concerned count ry and region. Amoxicillin, cefotaxim, the new fluoroquinolones and vancomy cin have exhibited the best preservation of efficacy worldwide. Resistance in Prance: Pneumococcal resistance is high in France against pen icillin, third-generation cephalosporins, and erythromycin. Resistance has however appeared to stabilize since 1997, with the exception of invasive st rains which have shown a rising level of penicillin C resistance. A new threat: Several authors have reported that vancomycin-tolerant strain s have a significant clinical importance and must be carefully monitored. R easonable prescription of antibiotics appears to be more than ever necessar y to reduce the selection pressure of antibiotics. (C) 2000, Masson, Paris.