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Antimicrobial resistance to benzylpenicillin in invasive pneumococcal disease in Belgium, 2003–2010: the effect of altering clinical breakpoints

  • M. C. GOOSSENS (a1), B. CATRY (a1) and J. VERHAEGEN (a2)
Summary
SUMMARY

The Belgian data (2003–2010) for the European Antimicrobial Resistance Surveillance Network (EARS-Net) showed a significant decreasing trend in the proportion of penicillin non-susceptible Streptococcus pneumoniae (9·4% to <1%) from blood and CSF isolates. We found that 75% of this decrease was explained by a change in Clinical and Laboratory Standards Institute (CLSI) breakpoints as the trend disappeared if only the new breakpoints were applied. Applying only European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints also resulted in a relatively stable proportion of penicillin non-susceptibility (average 5%), but this proportion was 7–13 times higher than with the new CLSI breakpoints. When the new CLSI breakpoints alone are used, fewer than 1% of bacteraemia isolates were penicillin non-susceptible during the entire period, but the proportion of non-susceptible meningitis isolates rose from 6·3% in 2003 to 15·9% between 2003 and 2010. Changing breakpoints should lead to retrospective analysis of historical data to minimize wrongly interpreting resistance trends.

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Copyright
The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence . The written permission of Cambridge University Press must be obtained for commercial re-use.
Corresponding author
*Author for correspondence: Dr M. C. Goossens, Scientific Institute of Public Health, Healthcare Associated Infections & Antimicrobial Resistance, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium. (Email: Mat.goossens@wiv-isp.be)
References
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4.Clinical Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 15th informational supplement M100-S15. Wayne, PA: CLSI, 2005.
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10.Drlica K, Perlin DS. Antibiotic Resistance: Understanding and Responding to an Emerging Crisis. New Jersey, USA: FT Press, 2011, pp. 5571.
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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