New penicillin susceptibility breakpoints for Streptococcus pneumoniae and their effects on susceptibility categorisation in Germany (1992–2008)

Abstract

Continuous nationwide surveillance of invasive pneumococcal disease (IPD) has been conducted in Germany. From 1992 to 2008, 12 137 IPD isolates were collected, including 2201 isolates (18.1%) from patients with meningitis and 9936 isolates (81.9%) from non-meningitis cases. Data on penicillin susceptibility were available for 11 814 invasive isolates. Categorisation of penicillin susceptibility according to the former Clinical and Laboratory Standards Institute (CLSI) guidelines resulted in 4.3% intermediate and 1.2% resistant isolates. When the new CLSI 2008 guidelines are applied, considerably higher resistance rates are observed in the meningitis group (6.5% resistant) than among the non-meningitis cases (0.0% resistant, 0.3% intermediate).