High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP study).
Jae-Hoon Song, Sook-In Jung, Kwan Soo Ko, Na Young Kim, Jun Seong Son, Hyun-Ha Chang, Hyun Kyun Ki, Won Sup Oh, Ji Yoeun Suh, Kyong Ran Peck, Nam Yong Lee, Yonghong Yang, Quan Lu, Anan Chongthaleong, Cheng-Hsun Chiu, M K Lalitha, Jennifer Perera, Ti Teow Yee, Gamini Kumarasinghe, Farida Jamal, Adeeba Kamarulzaman, Navaratnam Parasakthi, Pham Hung Van, Celia Carlos, Thomas So, Tak Keung Ng, Atef Shibl
Author Information
Jae-Hoon Song: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Asian-Pacific Research Foundation for Infectious Diseases, 50 Il-won dong, Kangnam-ku, Seoul 135-710, Korea. jhsong@smc.samsung.co.kr
A total of 685 clinical Streptococcus pneumoniae isolates from patients with pneumococcal diseases were collected from 14 centers in 11 Asian countries from January 2000 to June 2001. The in vitro susceptibilities of the isolates to 14 antimicrobial agents were determined by the broth microdilution test. Among the isolates tested, 483 (52.4%) were not susceptible to penicillin, 23% were intermediate, and 29.4% were penicillin resistant (MICs >/= 2 mg/liter). Isolates from Vietnam showed the highest prevalence of penicillin resistance (71.4%), followed by those from Korea (54.8%), Hong Kong (43.2%), and Taiwan (38.6%). The penicillin MICs at which 90% of isolates are inhibited (MIC(90)s) were 4 mg/liter among isolates from Vietnam, Hong Kong, Korea, and Taiwan. The prevalence of erythromycin resistance was also very high in Vietnam (92.1%), Taiwan (86%), Korea (80.6%), Hong Kong (76.8%), and China (73.9%). The MIC(90)s of erythromycin were >32 mg/liter among isolates from Korea, Vietnam, China, Taiwan, Singapore, Malaysia, and Hong Kong. Isolates from Hong Kong showed the highest rate of ciprofloxacin resistance (11.8%), followed by isolates from Sri Lanka (9.5%), the Philippines (9.1%), and Korea (6.5%). Multilocus sequence typing showed that the spread of the Taiwan(19F) clone and the Spain(23F) clone could be one of the major reasons for the rapid increases in antimicrobial resistance among S. pneumoniae isolates in Asia. Data from the multinational surveillance study clearly documented distinctive increases in the prevalence rates and the levels of antimicrobial resistance among S. pneumoniae isolates in many Asian countries, which are among the highest in the world published to date.
