Klugman K P, Koornhof H J, Kuhnle V
Am J Dis Child. 1986 Nov;140(11):1186-90. doi: 10.1001/archpedi.1986.02140250112045.
Routine surveillance of pneumococcal isolates for resistance to antibiotics has revealed the emergence of an unusual pattern of multiple antimicrobial resistance in South Africa. Thirty-nine pneumococcal isolates, including 21 from clinical specimens, showed resistance to tetracycline, erythromycin, clindamycin, trimethoprim, and a combination product of trimethoprim and sulfamethoxazole sodium (co-trimoxazole), yet susceptibility to penicillin G. Multiple resistance has to date been almost invariably associated with resistance to beta-lactam antibiotics. A survey of nasopharyngeal carriage revealed carriage of an additional 21 isolates of multiply resistant pneumococci, representing 7.9% of children investigated in Johannesburg, but these organisms were not found in children in Soweto or four rural villages. We present the minimum inhibitory concentrations of 15 antimicrobial agents against 15 of these 21 strains. These findings are discussed in relation to exposure of these populations to antibiotics and to the treatment of local and systemic pneumococcal disease. Of all 60 isolates of multiply resistant pneumococci isolated to date, those fully characterized serologically belong to serotypes 6B, 14, or 19F.
对肺炎球菌分离株进行抗生素耐药性的常规监测发现，南非出现了一种不寻常的多重抗菌耐药模式。39株肺炎球菌分离株，包括21株来自临床标本的菌株，对四环素、红霉素、克林霉素、甲氧苄啶以及甲氧苄啶和磺胺甲恶唑钠的复方制剂（复方新诺明）耐药，但对青霉素G敏感。迄今为止，多重耐药几乎总是与对β-内酰胺类抗生素耐药相关。一项鼻咽部带菌情况调查显示，另外还有21株多重耐药肺炎球菌分离株呈带菌状态，占约翰内斯堡接受调查儿童的7.9%，但在索韦托的儿童或四个乡村的儿童中未发现这些菌株。我们给出了15种抗菌药物对这21株菌株中15株的最低抑菌浓度。结合这些人群对抗生素的接触情况以及当地和全身性肺炎球菌疾病的治疗对这些发现进行了讨论。在迄今为止分离出的所有60株多重耐药肺炎球菌分离株中，经血清学完全鉴定的菌株属于6B、14或19F血清型。
