Two-year surveillance of antibiotic resistance in Streptococcus pneumoniaein four African cities

Worldwide spread of antibiotic resistance in Streptococcus pneumoniae is a major problem. However, data from West and North African countries are scar ce. To study the level of resistance and compare the situations in differen t cities, a prospective study was conducted in Abidjan (Ivory Coast), Casab lanca (Morocco), Dakar (Senegal), and Tunis (Tunisia), from 1996 to 1997. T he resistances to eight antibiotics of 375 isolates were studied by E test, and the results were interpreted using the breakpoints recommended by the National Committee for Clinical Laboratory Standards. Overall, 30.4% of the isolates were nonsusceptible to penicillin G (25.6% were intermediate and 4.8% were resistant). Amoxicillin (96.3% were susceptible) and parenteral t hird-generation cephalosporins (92.7%) were highly active. Resistance to ch loramphenicol was detected in 8.6% of the isolates. High levels of resistan ce were noted for erythromycin (28%), tetracycline (38.3%), and cotrimoxazo le (36.4%). Resistance to rifampin was rare (2.1%). There were significant differences in resistance rates between individual countries. Multiple resi stance was more frequent in penicillin-nonsusceptible isolates than in peni cillin-susceptible isolates. Recommendations for treatment could be generat ed from these results in each participating country.