Received 14 August
2002; revised 24 October 2002; electronically published 29 January 2003.
Thesurveillance of pneumococcal antibiotic
resistance and serotype distributionis hampered by therelatively low numbers ofinvasive pneumococcal infections.
InSwitzerland, a nationwide sentinelsurveillance
network was usedto assess antibiotic resistanceand
serotype distribution among1179 pneumococcal isolates culturedfrom 2769 nasopharyngeal swabsobtained from outpatients
withacute otitis media orpneumonia during 1998 and1999. The proportion ofpenicillin-susceptible pneumococcal
isolates overall(87%) and among infants<2 years old
(81%)was comparable to thatof invasive isolates (90%and 81%, respectively). Thehigh number of nasopharyngealisolates allowed for thedetection of a rapid
increase in the numberof penicillin-nonsusceptible pneumococcal
(PNSP)strains in the Westregion of Switzerland,
partlybecause of an epidemiccaused by the 19Fclone of Streptococcus pneumoniae. Clusteringof
risk factors forthe carriage of PNSPisolates further
explained thegeographic variation in resistance
rates. The nationwide sentinelsurveillance of nasopharyngeal
pneumococcusproved to be valuablefor the monitoring
ofantibiotic resistance, risk factorsfor carriage of
PNSPisolates, and serotype distributionand for the
detectionof the emergence ofa new epidemic clone.
Presentedin part: 39th InterscienceConference on Antimicrobial Agentsand Chemotherapy, San
Francisco,2629
September 1999 (abstract1042); 40th Interscience Conferenceon Antimicrobial Agents andChemotherapy, Toronto, 1620
September2000 (abstract 18093).
Thisstudy was performed accordingto the guidelines
onconduct of clinical researchof the ethical committeeof the State ofBern. Informed consent wasobtained
from the children'sparents by physicians inthe Sentinel
Working Group.
Financialsupport: Swiss National ScienceFoundation
(grant 3100-052955.97/1 toK.M.); Bayer; Bristol Mayers;
GlaxoSmithKline; Grünenthal; Lilly; Pfizer.
Noauthor has a commercialor other association thatmight pose a conflictof interest.
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