Original Article

Statewide Sentinel Surveillance for Antibiotic Nonsusceptibility among Streptococcus pneumoniae Isolates in South Carolina, 2003–2004

Authors: Daniel G. Dauner, PharmD, MSPH, Dixie F. Roberts, RN, MPH, George S. Kotchmar, MD

Abstract

Background: In 2003, the South Carolina Department of Health and Environmental Control established the Carolina Antibiotic Resistance Surveillance System (CARSS), an active sentinel surveillance system for antibiotic-resistant Streptococcus pneumoniae.


Methods: CARSS includes twelve hospitals. Each hospital was assigned a weighted sample size. Minimum inhibitory concentrations were determined using the E-test method.


Results: A total of 452 isolates were collected. The prevalence of penicillin nonsusceptibility in the study was 44.9%. Penicillin intermediate resistance (PCN-I) was 33.2%, and penicillin high-level resistance (PCN-R) was 11.7%. One hundred six (23.5%) isolates were nonsusceptible to one antibiotic. One hundred twenty-four (27.4%) isolates were nonsusceptible to three or more antibiotics.


Conclusions: CARSS confirmed the prevalences of antibiotic nonsusceptibility previously reported for South Carolina. However, CARSS suggests resistance is shifting from PCN-R to PCN-I in South Carolina. There is a high prevalence of multidrug nonsusceptibility in South Carolina. CARSS will continue to monitor these trends.


Key Points


* The prevalence of penicillin nonsusceptibility was 44.9%, with 33.2% of isolates being intermediate resistant and 11.7% being high-level resistant.


* The prevalence of azithromycin nonsusceptibility was 30.1%, with 3.2% of isolates being intermediate resistant and 26.9% being high-level resistant.


* The prevalence of levofloxacin nonsusceptibility was 1.6%, with 0.4% isolates being intermediate resistant and 1.1% being high-level resistant.


* The prevalence of isolates which were nonsusceptible to two or more antibiotics was 41.8%, and 27.4% were nonsusceptible to three or more antibiotics.

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