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  • Title: A significant increase in antimicrobial resistance among pneumococci causing invasive disease in New Zealand.
    Author: Brett MS, Martin DR.
    Journal: N Z Med J; 1999 Apr 09; 112(1085):113-5. PubMed ID: 10326798.
    Abstract:
    AIMS: To review the prevalence of antibiotic resistance and the distribution of capsular types among pneumococci from invasive disease in New Zealand from 1995 through 1997. METHOD: Pneumococci isolated from sterile sites that were referred to the Institute of Environmental Science and Research (ESR) were tested for antimicrobial susceptibility and capsular type. RESULTS: A total of 994 pneumococci were referred by 27 hospital and community laboratories. Almost 74% of the isolates were from patients aged < 15 years or > or = 60 years. The majority (88.2%) of the isolates were from blood cultures. In 1997, cefotaxime-resistant pneumococci were confirmed for the first time from invasive disease in New Zealand. Over the three years, 6.0% of the pneumococci were penicillin-nonsusceptible (MIC > or = 0.12 mg/L) and 3.7% were cefotaxime-nonsusceptible (MIC > or = 1 mg/L). Penicillin nonsusceptibility increased significantly from 1.9% in 1995 to 6.2% in 1996 and 9.9% in 1997. Similarly, cefotaxime nonsusceptibility increased from 0.6% in 1995 to 3.5% in 1996 and 6.9% in 1997. In descending order of frequency, the ten most common capsular types were 14, 19, 6, 9, 1, 4, 18, 7, 23, and 3. Eighty-three percent of the penicillin-nonsusceptible pneumococci belonged to serotypes 9V, 19A, 19F, 23F, 14 and 6B and 90% belonged to serotypes included in the 23-valent vaccine. CONCLUSIONS: The increasing prevalence of antimicrobial resistance among pneumococci highlights the need for continued surveillance and for effective measures to prevent pneumococcal infections.
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