Antibiotic susceptibility of respiratory bacterial isolates S179 P731 S. pneumoniae resistance patterns in a chest diseases hospital, for the decade 1997–2006 M. Makarona, H. Moraitou, N. Tsagarakis, S. Karabela, A. Gioga, I. Kouseris, V. Spyropoulos, S. Triantafyllou, A. Pefanis, S. Kanavaki (Athens, GR) Objectives: The aim of this study was to investigate the resistant patterns of S. pneumoniae strains isolated in ‘Sotiria’ Chest Diseases Hospital from 1997 to 2006, a period covering the last decade. Material and Methods: A total of 480 S. pneumoniae strains were isolated in our laboratory during the last decade. Most of them (373/480, 77.7%) derived from sputum samples, while 107/480 (22.3%) derived from different invasive infection sites, such as blood (61/480, 12.7%), pleural effusion (35/480, 7.29%) and CSF (5/480, 1.04%). Culture and susceptibility tests were performed according to NCCLS 2004 guidelines. All strains were tested by Kirby-Bauer disk diffusion method for penicillin, erythromycin, tetracycline, co-trimoxazole, ciprofloxacin and cefotaxime susceptibility. Oxacillin 1 mg/mL disks checked resistance to penicillin. Zone diameter 20 mm indicated Penicillin susceptible strains (PSSP) and 19 mm penicillin non- susceptible (PNSP). Penicillin MIC for PNSP strains was determined by E-test, according to NCCLS 2004 guidelines. Results: Regarding penicillin, 366/480 (76.25%) were PSSP strains and 114/480 (23.75%) were PNSP. A number of 92/114 (80.7%) showed intermediate resistance and 22/114 (19.3%) resistance. Most of the PNSPs (90/114, 78.9%) derived from sputum cultures. It is worthy of remark that 81/114 (71.0%) of PNSPs and 76/366 (20.7%) of PSSPs conferred resistance also to Erythromycin. Erythromycin resistance rates remained stable around 30% throughout the decade. Erythromycin MIC was performed on 108 strains and 48/108 (44.4%) showed high levels of resistance (MIC 128 mg/mL). Tetracycline resistance rate was at 14.6%. Cefotaxime resistance rate was at 1.0% and Ciprofloxacin at 2.0%. 96/480 (20.0%) strains proved multi-drug resistant (MDR), while 76/96 (79.0%) were PNSPs. Discussion: All medical practitioners should be aware of current S. pneumoniae resistance rates, before empirical treatment is offered to community-acquired respiratory system infections. P732 Comparison between respiratory and blood isolates of community-acquired Streptococcus pneumoniae from the UK and Ireland: resistance and serotypes R. Reynolds, D. Felmingham, R. Hope for the BSAC Working Parties on Resistance Surveillance Objective: Results from the BSAC Respiratory and Bacteraemia Resis- tance Surveillance Programmes were compared to identify differences between respiratory and blood isolates of S. pneumoniae. Methods: 31 centres collected 5083 community-acquired lower respiratory S. pneumoniae from 1999/2000 to 2005/06; 29 centres collected 1157 isolates from blood from 2001 to 2005. Ten of these centres contributed to both programmes. MICs were measured by BSAC methods in two central laboratories, one for each programme. Respiratory isolates from 2005/06 and all blood isolates were serotyped. The 285 blood isolates taken >48 hours after hospital admission differed from presumed community-acquired blood isolates in penicillin non- susceptibility (11% vs. 5%), patient age and sex, and were excluded from the results below. Logistic and multinomial logit models used robust errors to account for clustering of effects by centre. Results: The top ten serotypes in blood were 14, 1, 9V, 23F, 8, 4, 3, 19F, 6B, 22F (total 70%); this distribution did not vary significantly over 5 years. The distribution was different in respiratory isolates: the top ten were 19F, 23F, 6B, 3, 6A, 9V, 14, 11, 15, 19A (total 63%). Serotype distributions varied with age group but not with sex or care setting (community vs. hospital), and prevalence of penicillin non-susceptibility varied between serotypes. Penicillin non-susceptibility was more prevalent in respiratory than in blood isolates; this difference was apparent in each age group, sex and care setting, and within some common serotypes. Care setting and isolate source (respiratory vs. blood) were significant independent predictors of penicillin non-susceptibility; sex and age group were not. The role of serotype distribution is uncertain, as serotypes were too numerous to include satisfactorily in models, but it is unlikely to explain these effects completely since differences could be seen within some major serotypes. Conclusion: Penicillin non-susceptibility is uncommon in community- acquired S. pneumoniae in the UK and Ireland. It is more common in isolates from lower respiratory sources than those from blood, but some caution in interpretation is required as few centres contributed both blood and respiratory isolates. The serotype distribution of blood isolates was stable over 5 years. These results provide a baseline for comparison should serotype distributions and associated resistance change with future use of the 7-valent conjugate vaccine. S. pneumoniae penicillin non-susceptibility Non-susceptible Respiratory Blood N %PEN-NS N %PEN-NS All isolates 5065 8.3 843 4.7 Care setting community 2023 6.4 162 4.3 hospital (<48 hours) 3042 9.5 681 4.8 Age 0-19 481 8.9 114 6.1 20-59 1837 6.8 275 4.0 60 2742 9.2 447 4.9 Gender female 2074 7.0 406 4.9 male 2989 9.1 434 4.6 Serotype 14 38 34 135 3 23F 72 6 60 3 19F 83 10 43 2 9V 39 31 67 34 3 51 0 46 0 1 11 0 74 0 6B 53 9 32 6 P733 The first nationwide surveillance of bacterial respiratory pathogens conducted by the Japanese Society of Chemotherapy Y. Niki, S. Kohno, N. Aoki, A. Watanabe, M. Yagisawa, J. Sato, H. Hanaki on behalf of the JSC Surveillance Committee & The Kitasato Institute Objectives: The main approach in the control of antibiotic-resistant infections is through the precise usage of specific antimicrobial agents. Comprehensive data on susceptibilities of the major pathogens to currently available agents is currently lacking. In 2006 the Japanese Society of Chemotherapy (JSC) initiated a nationwide study of major bacterial RTI pathogens (Staphylococcus aureus, Streptococcus pneu- moniae, Streptococcus pyogenes, Haemophilus influenzae, Moraxella catarrhalis, Klebsiella pneumoniae and Pseudomonas aeruginosa) in Japan. Methods: A total of 924 clinical isolates from well-diagnosed adult RTI patients were obtained from 34 hospitals throughout Japan between January and April 2006. Susceptibility of these strains to 40 antimicrobial agents was tested at the central laboratory according to CLSI standards for broth microdilution method. Beta-lactamases were detected by the Nitrocefin disc method. Extended-spectrum b-lactamase (ESBL) and metallo-b-lactamase (MBL) were detected by the Cica-Beta Test (Kanto Chemical, Tokyo).