National surveillance programme on susceptibility patterns of respiratory pathogens in South Africa: moxifloxacin compared with eight other antimicrobial agents

• Published in: Journal of clinical pathology 2003-05, Vol.56 (5), p.344-347
• Main Authors: Liebowitz, L D, Slabbert, M, Huisamen, A
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - pharmacology; Antibacterial agents; antibiotic resistance; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimicrobial agents; Aza Compounds; Biological and medical sciences; CAMHB; cation adjusted Mueller-Hinton broth; Drug Resistance, Bacterial; Fluoroquinolones; Haemophilus influenzae - drug effects; haemophilus test medium; HTM; Humans; Laboratories; Medical sciences; Methodology; MIC; Microbial Sensitivity Tests; minimum inhibitory concentration; Moxifloxacin; National Committee for Clinical Laboratory Standards; NCCLS; Nosocomial infections; Organisms; Original; Pathogenic microorganisms; Penicillin; Pharmacology. Drug treatments; Pneumonia; Population Surveillance; Quinolines; respiratory tract infection; Respiratory Tract Infections - drug therapy; Respiratory Tract Infections - microbiology; South Africa; Streptococcus infections; Streptococcus pneumoniae - drug effects; Streptococcus pyogenes - drug effects; Surveillance
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jcp.56.5.344

Aims: The susceptibility patterns of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Klebsiella pneumoniae, and Streptococcus pyogenes isolated from specimens submitted to 12 private laboratories in South Africa were determined. Methods: Minimum inhibitory concentration (MIC) determinations were performed on the isolates in the microbiology laboratory at Tygerberg Hospital according to the recommendations of the National Committee for Clinical Laboratory Standards (NCCLS). Results: According to the NCCLS breakpoints, 24% of 729 S pneumoniae isolates were sensitive, 30% intermediate, and 46% resistant to penicillin. Rates of macrolide resistance were high, with 61% of the pneumococci being resistant to clarithromycin and azithromycin. Co-trimoxazole resistance was also high, with 28% of pneumococcal strains being sensitive, 21% intermediate, and 51% resistant. β Lactamase was produced by 7% of 736 H influenzae isolates and 91% of 256 M catarrhalis isolates. The quinolones, moxifloxacin and levofloxacin, were universally active against all isolates tested, which included S pneumoniae, H influenzae, M catarrhalis, K pneumoniae, and S pyogenes. Conclusions:Haemophilus influenzae and S pneumoniae were the most commonly isolated organisms. Resistance to penicillin was one of the highest reported in the world (76%) in S pneumoniae, as was macrolide resistance in pneumonocci, although surprisingly, only 14% of S pyogenes were resistant. The quinolones, moxifloxacin and levofloxacin, were active against all organisms tested, including the penicillin and macrolide resistant strains and moxifloxacin was more active than levofloxacin against pneumococci.