… and Merseyside ..

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7060.820 (Published 28 September 1996) Cite this as: BMJ 1996;313:820
  1. K D Allen, Consultant microbiologist,
  2. J J Anson, Senior registrar
  1. Medical Microbiology, Whiston Hospital, Prescot L35 5DR

    EDITOR,—Alan P Johnson and colleagues report that the prevalence of resistance to penicillin in pneumococci was 3.9% in Britain in 1995.1 In some areas, however, the prevalence is higher than this.

    In 1995, 60 (7.5%) of 798 of our pneumococcal isolates were resistant to penicillin. Forty one isolates were from children (average age 2.2 years), of whom nine (22%) were infected, and 19 were from adults (average age 64), of whom 16 (84%) were infected. In total, 25 patients developed an infection: chest infection (19), eye infection (3), sinusitis (1), otitis media (1), and bacteraemia (1). Only three patients had a history of travel (to Tenerife, Turkey, and the Republic of Ireland) within the previous three months. Thirty three patients had received antibiotics in the previous three months; 20 (60%) of the prescriptions had been for penicillins or cephalosporins. In comparison, 53% of all antibiotics prescribed in this district are for these drugs.

    The most common serotype was serotype 9 (335 isolates), followed by serotype 6 (223), serotype 19 (96), and serotype 23 (96) (Streptococcus and Diphtheria Reference Unit, Central Public Health Laboratory). Two hundred and thirty nine isolates (30%) exhibited high level resistance to penicillin (minimum inhibitory concentration >1 mg/l). Full resistance to cefotaxime occurred in only one isolate (2%) (Antibiotic Reference Unit, Central Public Health Laboratory).

    The rate of resistance to penicillin in pneumococci in our district has increased inexorably since 1987, when the first resistant isolate appeared. This rise seems likely to continue.


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