[Evolution of the resistance of Streptococcus pneumoniae to erythromycin at the Pitié-Salpêtrière Hospital (1980-1984)]

Abstract

From January 1980 to December 1984, 563 swabs for Streptococcus pneumoniae were isolated at the Pitié-Salpêtrière hospital in Paris, and of these 63 were resistant to erythromycin. The percentage of swabs resistant to erythromycin rose from 2.7% in 1980 to 19.6% in 1984 and was similar for cultures of blood, serous fluid, bronchial secretions, otolaryngological specimens and smears from the conjunction. For swabs resistant to erythromycin these belonged almost exclusively (57 out of 60 or 90%) to the serotypes 6, 14, 19 and 23; one may ask whether the rise in resistance of S. pneumoniae to erythromycin was due to a rise in the frequency of isolation of these serotypes? Between 1980 and 1984 such rise took place since the frequency of isolation of S. pneumoniae belonging to the serotypes 6, 14, 19 or 23 rose from 38% in 1980 to 50% in 1984, but the rise was not significant (p = 0.1). In fact S. pneumoniae serotypes 6, 14, 19 or 23 have become resistant is significant (p less than 0.05). Two factors should be taken into consideration when interpreting these facts. The first is the increased consumption of macrolide antibiotics which doubled overall between 1979 and 1983, both at the Pitié-Salpêtrière hospital and in the Public Assistance hospitals of Paris as well as provincial hospitals throughout France. The second factor is the strictly hospital nature of this study which may have led to an overestimation of the frequency of resistance of S. pneumoniae to erythromycin.