Table 2.
MIC and susceptibility results for S. pneumoniae isolates by country
| Susceptibility |
||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MIC (mg/L) |
CLSI |
PK/PD |
EUCAST |
|||||||||
| Antimicrobial | na | 50% | 90% | min | max | %S | %I | %R | %S | %S | %I | %R |
| India | ||||||||||||
| AMCb,c | 219 | 0.06 | 2 | ≤0.015 | >256 | 91.8 | 2.7 | 5.5 | 91.8 (94.5) | NA | NA | NA |
| azithromycind | 199 | 1 | >256 | ≤0.015 | >256 | 66.3 | 13.6 | 20.1 | NA | NA | NA | NA |
| cefixime | 219 | 2 | 32 | ≤0.015 | >256 | NA | NA | NA | 49.8 | NA | NA | NA |
| cefpodoxime | 219 | 0.25 | 4 | ≤0.015 | >256 | 67.1 | 9.1 | 23.7 | 67.1 | 55.3 | 11.9 | 32.9 |
| cefuroximee | 218 | 0.25 | 4 | ≤0.015 | >256 | 75.2 | 8.7 | 16.1 | 75.2 | 51.4 | 13.8 | 34.9 |
| clarithromycind | 199 | 0.25 | >256 | ≤0.015 | >256 | 54.8 | 2.0 | 43.2 | NA | NA | NA | NA |
| erythromycind | 183 | 0.25 | >256 | ≤0.015 | >256 | 57.4 | 8.2 | 34.4 | NA | 57.4 | 8.2 | 34.4 |
| levofloxacin | 219 | 1 | >32 | 0.12 | >32 | 85.8 | 3.2 | 11.0 | 85.8 | 85.8 | 0.0 | 14.2 |
| ofloxacin | 219 | 2 | >32 | 0.5 | >32 | 77.2 | 9.1 | 13.7 | NA | 0.0 | 86.3 | 13.7 |
| penicillin (oral) | 219 | 0.12 | 2 | ≤0.015 | >32 | 49.3 | 33.8 | 16.9 | NA | 49.3 | 46.1 | 4.6 |
| penicillin (iv) | 219 | 0.12 | 2 | ≤0.015 | >32 | 95.4 | 2.7 | 1.8 | NA | 73.5–95.4 | NA | NA |
| SXT | 219 | 1 | 16 | ≤0.015 | >32 | 32.9 | 39.3 | 27.9 | 32.9 | 55.3 | 16.9 | 27.8 |
| erythromycinf | 218 | — | — | — | — | 49.1 | 12.8 | 38.1 | — | 49.1 | 4.6 | 46.3 |
| South Korea | ||||||||||||
| AMCb,c | 85 | 1 | 4 | ≤0.015 | 8 | 81.2 | 16.5 | 2.4 | 81.2 (97.6) | NA | NA | NA |
| azithromycind | 85 | >256 | >256 | 0.12 | >256 | 20.0 | 1.2 | 78.8 | NA | NA | NA | NA |
| cefaclor | 85 | 32 | >256 | 0.12 | >256 | 24.7 | 3.5 | 71.8 | 23.5 | 0.0 | 23.5 | 76.5 |
| cefotaxime | 85 | 0.5 | 2 | ≤0.015 | 32 | 85.9 | 5.9 | 8.2 | NA | 50.6 | 41.2 | 8.2 |
| cefuroximee | 85 | 2 | 8 | ≤0.015 | >256 | 36.5 | 18.8 | 44.7 | 36.5 | 29.4 | 0.0 | 70.6 |
| clarithromycind | 85 | >256 | >256 | 0.06 | >256 | 18.8 | 0.0 | 81.2 | NA | NA | NA | NA |
| clindamycind | 85 | >256 | >256 | ≤0.015 | >256 | 31.8 | 1.2 | 67.1 | NA | NA | NA | NA |
| levofloxacin | 85 | 1 | 2 | 0.25 | >32 | 91.8 | 0.0 | 8.2 | 91.8 | 91.8 | 0.0 | 8.2 |
| ofloxacin | 85 | 2 | 4 | 1 | >32 | 75.3 | 16.5 | 8.2 | NA | 0.0 | 91.8 | 8.2 |
| penicillin (oral) | 85 | 1 | 4 | ≤0.015 | 16 | 21.2 | 35.3 | 43.5 | NA | 21.2 | 57.6 | 21.2 |
| penicillin (iv) | 85 | 1 | 4 | ≤0.015 | 16 | 78.8 | 17.7 | 3.5 | NA | 37.6–78.8 | NA | NA |
| SXT | 85 | 1 | >32 | 0.12 | >32 | 43.5 | 11.8 | 44.7 | 43.5 | 54.1 | 1.2 | 44.7 |
| erythromycinf | 85 | — | — | — | — | 18.8 | 0.0 | 81.2 | — | 17.6 | 1.2 | 81.2 |
| Singapore | ||||||||||||
| AMCb,c | 58 | 0.03 | 2 | ≤0.015 | 4 | 94.8 | 5.2 | 0.0 | 94.8 (100) | NA | NA | NA |
| azithromycind | 58 | 2 | >256 | 0.25 | >256 | 56.9 | 5.2 | 37.9 | NA | NA | NA | NA |
| cefaclor | 58 | 1 | >256 | 0.5 | >256 | 67.2 | 5.2 | 27.6 | 19.0 | 0.0 | 19.0 | 81.0 |
| cefuroximee | 58 | 0.06 | 4 | ≤0.015 | 32 | 79.3 | 3.5 | 17.2 | 79.3 | 72.4 | 3.5 | 24.1 |
| clarithromycind | 58 | 0.25 | >256 | 0.06 | >256 | 56.9 | 0.0 | 43.1 | NA | NA | NA | NA |
| levofloxacin | 58 | 1 | 2 | 0.5 | 4 | 98.3 | 1.7 | 0.0 | 98.3 | 98.3 | 0.0 | 1.7 |
| moxifloxacin | 58 | 0.12 | 0.25 | 0.06 | 0.25 | 100 | 0.0 | 0.0 | 100 | 100 | 0.0 | 0.0 |
| ofloxacin | 58 | 4 | 4 | 0.06 | 8 | 43.1 | 53.5 | 3.5 | NA | 1.7 | 94.8 | 3.5 |
| penicillin (oral) | 58 | 0.03 | 2 | ≤0.015 | 4 | 63.8 | 25.9 | 10.3 | NA | 63.8 | 31.0 | 5.2 |
| penicillin (iv) | 58 | 0.03 | 2 | ≤0.015 | 4 | 94.8 | 5.2 | 0.0 | NA | 81.0–94.8 | NA | NA |
| SXT | 58 | 1 | >32 | 0.12 | >32 | 43.1 | 10.3 | 46.6 | 43.1 | 50.0 | 3.5 | 46.6 |
| erythromycinf | 58 | — | — | — | — | 55.2 | 1.7 | 43.1 | — | 55.2 | 0.0 | 44.8 |
| Thailand | ||||||||||||
| AMCb,c | 208 | 0.06 | 1 | ≤0.015 | 32 | 97.1 | 1.9 | 1.0 | 97.1 (99.0) | NA | NA | NA |
| azithromycind | 208 | 2 | >256 | 0.03 | >256 | 53.4 | 1.0 | 45.7 | NA | NA | NA | NA |
| cefuroximee | 208 | 0.12 | 2 | ≤0.015 | 32 | 77.9 | 16.3 | 5.8 | 77.9 | 59.1 | 7.2 | 33.7 |
| clarithromycind | 208 | 0.25 | >256 | 0.03 | >256 | 52.4 | 0.0 | 47.6 | NA | NA | NA | NA |
| levofloxacin | 208 | 1 | 2 | 0.5 | 16 | 98.1 | 1.4 | 0.5 | 98.1 | 98.1 | 0.0 | 1.9 |
| penicillin (oral) | 208 | 0.12 | 1 | ≤0.015 | 8 | 49.0 | 46.2 | 4.8 | NA | 49.0 | 49.0 | 1.9 |
| penicillin (iv) | 208 | 0.12 | 1 | ≤0.015 | 8 | 98.1 | 1.0 | 1.0 | NA | 84.1–98.1 | NA | NA |
| erythromycinf | 208 | — | — | — | — | 51.9 | 1.9 | 46.2 | NA | 51.9 | 0.0 | 48.1 |
min, minimum; max, maximum; S, susceptible; I, intermediate; R, resistant; AMC, amoxicillin/clavulanic acid; NA, no breakpoint data available (NA for azithromycin, clindamycin and clarithromycin by EUCAST or PK/PD because Etest® breakpoints in CO2 not available); SXT, trimethoprim/sulfamethoxazole.
aNot all isolates were tested. Although amoxicillin has not been tested against S. pneumoniae, percentage susceptibility to amoxicillin and amoxicillin/clavulanic acid is expected to be the same.
bPK/PD susceptibility at high dose is shown in parentheses.
cFor S. pneumoniae susceptibility to amoxicillin alone can be inferred from amoxicillin/clavulanic acid data.
dbioMérieux Etest® breakpoints for incubation in CO2.
eBreakpoints used are for cefuroxime axetil.
fUsing S/I/R zone diameters (mm) of CLSI (≤15/16–20/≥21) and EUCAST (≤18/19–21/≥22).