Streptococcus pneumoniae:: current aspects of antibiotic resistance

A worldwide issue: Streptococcus pneumoniae is an important pathogen implicated in many illnesses. The susceptibility of this bacteria has greatly changed since 1967 when it was the leading strain resistant to penicillin C. Since that rime, the resistance of S. pneumoniae has become a worldwide problem leading to the development of schemes to monitor resistance in different countries. The analysis of these "observation" studies points out the wide variability of resistance to antibiotics depending on the concerned country and region. Amoxicillin, cefotaxim, the new fluoroquinolones and vancomycin have exhibited the best preservation of efficacy worldwide. Resistance in Prance: Pneumococcal resistance is high in France against penicillin, third-generation cephalosporins, and erythromycin. Resistance has however appeared to stabilize since 1997, with the exception of invasive strains which have shown a rising level of penicillin C resistance. A new threat: Several authors have reported that vancomycin-tolerant strains have a significant clinical importance and must be carefully monitored. Reasonable prescription of antibiotics appears to be more than ever necessary to reduce the selection pressure of antibiotics. (C) 2000, Masson, Paris.