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• W2012861710 abstract "Surveillance of antibiotic resistance provides information on which to base policies and to assess their efficacy. The recent UK House of Lords Select Committee report on resistance to antimicrobials states that surveillance is vital to the fight against resistance.1Select Committee on Science and Technology Resistance to antibiotics. House of Lords. March 17, 1998. Stationery Office, London1998Google Scholar It goes without saying that the data generated by such surveillance must be relevant to the intended audience. Statements on the resistance rate of a particular pathogen to an antimicrobial has little immediate clinical relevance if the figure varies widely in different areas. This point was shown in a recent study undertaken to assess the resistance of gram-positive pathogens including Streptococcus pneumoniae during the winter of 1996–97. 30 hospitals around the UK sent their consecutive respiratory-tract isolates to a central laboratory where antimicrobial susceptibility was tested by agar dilution measurement of minimum inhibitory concentrations.2Working Party of the British Society for Antimicrobial Chemotherapy 1991. A guide to sensitivity testing.Antimicrob Chemother. 1991; 37: 22-30Google Scholar The resistance rates of S pneumoniae to penicillin in selected centres and the combined results for all 30 hospitals are shown in the table.TablePenicillin resistance rates of pneumoniae in selection from 30 UK centresCentreIntermediate resistance (%) (MIC ¶0·12 (>1 mg/L)High-level resistance (%) (MIC >1 mg/L)Combined results for 30 centres3·33·3Sheffield00Leicester00Belfast Hospital A15·430·8Belfast Hospital B55Southampton11·10Birmingham517·5Dudley102·5MIC-minimum inhibitory concentration. Total number of isolates studied=1040 Open table in a new tab MIC-minimum inhibitory concentration. Total number of isolates studied=1040 The combined results show an equal and low rate of intermediate (I) and high-level (H) resistance to S pneumoniae. Similar rates were found in hospital B, in Belfast. This information would be of little clinical relevance in Belfast hospital A where the resistance rates to penicillin (I+H combined) was 46·2%. In a Birmingham hospital, the H rate greatly exceeded that of the combined results, whereas the I was similar. In nearby Dudley (and in Southampton) the position is reversed. Hospitals in Leicester and Sheffield had no proven resistance to S pneumoniae. The reasons for these major differences may reflect the types of specimen submitted to each laboratory, but variable spread of resistant clones is also possible3Tomasz A The pneumococcus of the pates.N Engl J Med. 1995; 333: 514-515Crossref PubMed Scopus (73) Google Scholar and these will be the subject of further study. There is a a need for local hospitals to undertake their own surveillance to make informed decisions on local antibiotic advice. Such surveillance should be repeated in a regular basis. Others have suggested quarterly surveillance;4Report of the ASM Task Force on Antibiotic Resistance. American Society of Microbiology, Washington DC1995Google Scholar however, the frequency will be decided by the locality and the pathogen under study. Reliance on national data may be unhelpful in this regard." @default.
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• W2012861710 date "1998-08-01" @default.
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• W2012861710 title "Local surveillance of antimicrobial resistance" @default.
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• W2012861710 doi "https://doi.org/10.1016/s0140-6736(05)79618-5" @default.
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