JAC Advance Access published online on October 29, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg461
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Department of Medical
Microbiology, North Bristol NHS Trust, Southmead Hospital, Bristol
BS10 5NB;
* Corresponding author. E-mail: rosy.reynolds{at}btinternet.com.
Received 1 July 2003
; revised 26 August 2003
; accepted 28 August 2003
Objective: The aim of this study was
to assess the antimicrobial susceptibility of community-acquired
lower respiratory pathogens in Great Britain and Ireland, and investigate
its relationship with demographic and geographical factors using
multiple logistic regression analysis. Methods: A total of 1328 isolates of Streptococcus
pneumoniae, 1894 Haemophilus influenzae and
845 Moraxella catarrhalis were collected from lower
respiratory clinical specimens (primarily sputum) by 20 laboratories
in Great Britain (England, Wales and Scotland) and Ireland (Northern
Ireland and Eire) between 1999 and 2001. Results: Of 1154 S. pneumoniae from
Great Britain, 92-100% were susceptible to Conclusions: Clinically relevant demographic
factors predictive of susceptibility were country and patient age
in S. pneumoniae, and specimen type (sputum/non-sputum)
in H. influenzae. Susceptibility to most antimicrobials
remains high in Ireland and very high in Great Britain.
Keywords: antibacterial, resistance epidemiology, British
Isles
Antimicrobial susceptibility of lower respiratory
tract pathogens in Great Britain and Ireland 1999-2001
related to demographic and geographical factors: the BSAC Respiratory
Resistance Surveillance Programme
2 GR Micro Ltd, 7-9
William Road, London NW1 3ER, UK
-lactams (only 0.2% having
penicillin MICs 
2 mg/L), 89% were
susceptible to erythromycin, 93% susceptible to tetracycline,
and 94-100% intermediate or susceptible to fluoroquinolones.
Susceptibility to agents other than fluoroquinolones was less frequent
in the 174 isolates from Ireland: -lactam
susceptibility was 68-99% (3.4% having
penicillin MICs 2 mg/L), erythromycin
susceptibility was 78% and tetracycline susceptibility
was 82%. In multivariate analysis, susceptibility in S. pneumoniae was associated with country and patient
age, being most common overall in the 20-49 years age group.
Of 1894 H. influenzae, 15% produced -lactamase and 79-100% were
susceptible to -lactams other than
cefaclor. Ninety-six per cent were intermediate and 1% susceptible to
erythromycin, 97% susceptible to tetracycline, and 89% susceptible
to trimethoprim. Only one isolate showed resistance to ciprofloxacin. H. influenzae from sputum were more likely to be
susceptible than isolates from other sources. Of 845 M.
catarrhalis, 92% produced -lactamase
and 9% were susceptible to ampicillin, >99% were
susceptible to co-amoxiclav, cefotaxime, erythromycin and fluoroquinolones.
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