[Evolution of the antibiotic resistance of Streptococcus pneumoniae from 1997 to 2004 at Hôtel-Dieu de France, a university hospital in Lebanon].

Various rates of Streptococcus pneumoniae with diminished susceptibility to Penicillin G (PNSP) are reported worldwide, while resistance to cefotaxime and ceftriaxone is actually increasing among S. pneumoniae. The aim of this survey was to determine the evolution of the susceptibility and resistance of S. pneumoniae at our hospital, throughout the years 1997-2004. 582 S. pneumoniae strains, isolated from different patients with pulmonary disease, otitis media, bacteremia and/or meningitis have been observed. MIC to benzylpenicillin (P), ampicillin (AMP) and ceftriaxone (CRO) were determined by E-TEST. Susceptibility to erythromycin (ERY), cotrimoxazole (SXT), tetracycline (TE) and rifampicin (RA) were determined by agar diffusion. All tests were interpreted according to CA-SFM guidelines. The percentage of PNSP varied between 49.6 and 69%. S. pneumoniae with reduced susceptibility to benzylpenicillin had stable rates, while fully resistant S. pneumoniae decreased significantly. Resistance to ampicillin varied alongside with penicillin with a decrease of fully resistant S. pneumoniae. Strains intermediate to ceftriaxone also decreased significantly while those fully resistant were not detected, except for 1999 (1 strain). The resistance (I+R) to SXT and TE remained stable with small variations, but resistance to ERY increased up to 43% of isolated strains in 2004. Resistance to LVX and RA was absent, with unexpected levels for RA (1 and 5%) in 2002 and 2003.