Antimicrobial resistance of Streptococcus pneumoniae isolated in Taiwan: An island-wide surveillance study between 1996 and 1997

Chang Phone Fung, Bor Shen Hu, Sai Cheong Lee, Peter Yuk Fong Liu, Tsrang Neng Jang, Hsieh Shong Leu, Benjamin I. Kuo, Muh Yung Yen, Cheng Yi Liu, Yung Chin Liu, Yeu Jun Lau, Kwok Woon Yu

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Between August 1996 and July 1997, 550 clinically significant Streptococcus pneumoniae isolates were collected from 14 geographically separate laboratories in Taiwan. These isolates were serotyped and MICs were determined by agar dilution. Among serotypes covered by the 23-valent vaccine, types 19F, 19A, 23F, 23A and 6B dominated, comprising 255 isolates; among non-vaccine serotypes, types 35, 39, 34, 13 and 31 dominated, comprising 118 isolates. Of the 550 isolates, 310 (56.4%) were resistant to penicillin G (MIC ≥ 0.12 mg/L), 238 (43.3%) with intermediate resistance (MIC 0.12-1 mg/L) and 72 (13.1%) with high-level resistance (MIC ≥ 2 mg/L). Most non-susceptible pneumococci were of serotypes 19F and 23F; non-susceptible isolates of these serotypes were distributed across all of Taiwan. Fourteen other antibiotics were tested; 83% of the isolates were resistant to tetracycline, 78% to azithromycin, 74% to erythromycin, 54% to clindamycin and 23% to chloramphenicol. Thus, macrolides can no longer be used as first line agents to treat pneumococcal infections in Taiwan. Multi-resistance (isolates resistant to three or more chemically unrelated antibiotics) was found in each serotype or group, but mostly in types 19F and 23F. The emergence of such strains complicates antibiotic selection, but both types are covered by the 23-valent vaccine, as were 82% of the isolates from blood and eight of the nine from cerebrospinal fluid. Good antibiotic control and appropriate use of this vaccine may improve the current problem in Taiwan, especially for the elderly.

Original languageEnglish
Pages (from-to)49-55
Number of pages7
JournalJournal of Antimicrobial Chemotherapy
Volume45
Issue number1
Publication statusPublished - 2000
Externally publishedYes

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Streptococcus pneumoniae
Taiwan
Islands
Anti-Bacterial Agents
Pneumococcal Infections
Azithromycin
Penicillin G
Clindamycin
Macrolides
Chloramphenicol
Erythromycin
Tetracycline
Agar
Cerebrospinal Fluid
Vaccines
Serogroup
23-valent pneumococcal capsular polysaccharide vaccine

ASJC Scopus subject areas

  • Pharmacology
  • Microbiology

Cite this

Fung, C. P., Hu, B. S., Lee, S. C., Liu, P. Y. F., Jang, T. N., Leu, H. S., ... Yu, K. W. (2000). Antimicrobial resistance of Streptococcus pneumoniae isolated in Taiwan: An island-wide surveillance study between 1996 and 1997. Journal of Antimicrobial Chemotherapy, 45(1), 49-55.

Antimicrobial resistance of Streptococcus pneumoniae isolated in Taiwan : An island-wide surveillance study between 1996 and 1997. / Fung, Chang Phone; Hu, Bor Shen; Lee, Sai Cheong; Liu, Peter Yuk Fong; Jang, Tsrang Neng; Leu, Hsieh Shong; Kuo, Benjamin I.; Yen, Muh Yung; Liu, Cheng Yi; Liu, Yung Chin; Lau, Yeu Jun; Yu, Kwok Woon.

In: Journal of Antimicrobial Chemotherapy, Vol. 45, No. 1, 2000, p. 49-55.

Research output: Contribution to journalArticle

Fung, CP, Hu, BS, Lee, SC, Liu, PYF, Jang, TN, Leu, HS, Kuo, BI, Yen, MY, Liu, CY, Liu, YC, Lau, YJ & Yu, KW 2000, 'Antimicrobial resistance of Streptococcus pneumoniae isolated in Taiwan: An island-wide surveillance study between 1996 and 1997', Journal of Antimicrobial Chemotherapy, vol. 45, no. 1, pp. 49-55.
Fung, Chang Phone ; Hu, Bor Shen ; Lee, Sai Cheong ; Liu, Peter Yuk Fong ; Jang, Tsrang Neng ; Leu, Hsieh Shong ; Kuo, Benjamin I. ; Yen, Muh Yung ; Liu, Cheng Yi ; Liu, Yung Chin ; Lau, Yeu Jun ; Yu, Kwok Woon. / Antimicrobial resistance of Streptococcus pneumoniae isolated in Taiwan : An island-wide surveillance study between 1996 and 1997. In: Journal of Antimicrobial Chemotherapy. 2000 ; Vol. 45, No. 1. pp. 49-55.
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abstract = "Between August 1996 and July 1997, 550 clinically significant Streptococcus pneumoniae isolates were collected from 14 geographically separate laboratories in Taiwan. These isolates were serotyped and MICs were determined by agar dilution. Among serotypes covered by the 23-valent vaccine, types 19F, 19A, 23F, 23A and 6B dominated, comprising 255 isolates; among non-vaccine serotypes, types 35, 39, 34, 13 and 31 dominated, comprising 118 isolates. Of the 550 isolates, 310 (56.4{\%}) were resistant to penicillin G (MIC ≥ 0.12 mg/L), 238 (43.3{\%}) with intermediate resistance (MIC 0.12-1 mg/L) and 72 (13.1{\%}) with high-level resistance (MIC ≥ 2 mg/L). Most non-susceptible pneumococci were of serotypes 19F and 23F; non-susceptible isolates of these serotypes were distributed across all of Taiwan. Fourteen other antibiotics were tested; 83{\%} of the isolates were resistant to tetracycline, 78{\%} to azithromycin, 74{\%} to erythromycin, 54{\%} to clindamycin and 23{\%} to chloramphenicol. Thus, macrolides can no longer be used as first line agents to treat pneumococcal infections in Taiwan. Multi-resistance (isolates resistant to three or more chemically unrelated antibiotics) was found in each serotype or group, but mostly in types 19F and 23F. The emergence of such strains complicates antibiotic selection, but both types are covered by the 23-valent vaccine, as were 82{\%} of the isolates from blood and eight of the nine from cerebrospinal fluid. Good antibiotic control and appropriate use of this vaccine may improve the current problem in Taiwan, especially for the elderly.",
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AU - Liu, Peter Yuk Fong

AU - Jang, Tsrang Neng

AU - Leu, Hsieh Shong

AU - Kuo, Benjamin I.

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AU - Liu, Yung Chin

AU - Lau, Yeu Jun

AU - Yu, Kwok Woon

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N2 - Between August 1996 and July 1997, 550 clinically significant Streptococcus pneumoniae isolates were collected from 14 geographically separate laboratories in Taiwan. These isolates were serotyped and MICs were determined by agar dilution. Among serotypes covered by the 23-valent vaccine, types 19F, 19A, 23F, 23A and 6B dominated, comprising 255 isolates; among non-vaccine serotypes, types 35, 39, 34, 13 and 31 dominated, comprising 118 isolates. Of the 550 isolates, 310 (56.4%) were resistant to penicillin G (MIC ≥ 0.12 mg/L), 238 (43.3%) with intermediate resistance (MIC 0.12-1 mg/L) and 72 (13.1%) with high-level resistance (MIC ≥ 2 mg/L). Most non-susceptible pneumococci were of serotypes 19F and 23F; non-susceptible isolates of these serotypes were distributed across all of Taiwan. Fourteen other antibiotics were tested; 83% of the isolates were resistant to tetracycline, 78% to azithromycin, 74% to erythromycin, 54% to clindamycin and 23% to chloramphenicol. Thus, macrolides can no longer be used as first line agents to treat pneumococcal infections in Taiwan. Multi-resistance (isolates resistant to three or more chemically unrelated antibiotics) was found in each serotype or group, but mostly in types 19F and 23F. The emergence of such strains complicates antibiotic selection, but both types are covered by the 23-valent vaccine, as were 82% of the isolates from blood and eight of the nine from cerebrospinal fluid. Good antibiotic control and appropriate use of this vaccine may improve the current problem in Taiwan, especially for the elderly.

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