Emergence of extremely high penicillin and cefotaxime resistance and high-level levofloxacin resistance in clinical isolates of Streptococcus pneumoniae in Hungary

Oxacillin disc diffusion tests revealed that 36.7% of 327 Hungarian Streptococcus pneumoniae strains from clinical specimens were not penicillin susceptible. Determination of the MICs of penicillin, cefotaxime and levofloxacin for these strains by Etest confirmed that 30 (9.2%), 19 (5.8%) and four to 11 (1.2-3.4%) were fully penicillin-, cefotaxime- and levofloxacin-resistant, respectively. Most had extremely high MICs. Lower respiratory tract strains were more resistant than those from the upper respiratory tract. Levofloxacin-resistant strains were either penicillin intermediate or resistant, but their MICs did not correlate strongly.