Journal of Antimicrobial Chemotherapy, Vol 41, 93-101, Copyright © 1998 by The British Society for Antimicrobial Chemotherapy
AJ de Neeling, WJ van Leeuwen, LM Schouls, CS Schot, A van Veen-Rutgers, AJ Beunders, AG Buiting, C Hol, EE Ligtvoet, PL Petit, LJ Sabbe, AJ van Griethuysen and JD van Embden
An electronic surveillance network for monitoring antibiotic resistance in
The Netherlands has been in operation since 1989. Seven public health
laboratories participate and the system covers about 25% of all
bacteriological determinations in The Netherlands. This paper reports the
results of staphylococci isolated in the period 1989-1995. About 0.3% of
the Staphylococcus aureus isolates in the study period were resistant to
methicillin. This low percentage may be due to the restrictive use of
antibiotics and to strict isolation measures aimed at eradicating
methicillin-resistant S. aureus. Low frequencies of resistance among
methicillin-resistant S. aureus were found for vancomycin (0%),
chloramphenicol (11%), cotrimoxazole (11%), mupirocin (3% low-level
resistance) and fusidic acid (7%). Twenty-one percent of the
coagulase-negative staphylococci were resistant to methicillin. Low
frequencies of resistance among these methicillin-resistant coagulase-
negative staphylococci were those to vancomycin (0.4%), nitrofurantoin
(2%), doxycycline (20%) and amikacin (20%). Coagulase-negative
staphylococci from cerebrospinal fluid, blood and skin were less often
resistant to quinolones than isolates from respiratory tract, faeces and
urine. A significant increase in resistance of coagulase-negative
staphylococci to methicillin, erythromycin, gentamicin and ciprofloxacin
was observed in the investigated period but the resistance to doxycycline
and co-trimoxazole decreased in the last few years. To confirm the
determination of methicillin resistance and coagulase production, a PCR
method was developed which detects both the mecA and the coagulase gene.
The results of the PCR method correlated well with the methicillin MIC as
determined by an agar-dilution method.
ORIGINAL ARTICLES
Resistance of staphylococci in The Netherlands: surveillance by an electronic network during 1989-1995
National Institute of Public Health and the Environment, Bilthoven, The Netherlands. Han.de.Neeling@rivm.nl
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