In 1996, the Alexander Project, an international multi-centre study on the antimicrobial susceptibility of bacterial pathogens isolated from community-acquired lower respiratory tract infections (LRTI) commenced in Poland. Altogether 506 bacterial isolates were collected from sputum, broncho-alveolar and blood samples taken from patients diagnosed with LRTI. Of these, 262 were identified as Haemophilus influenzae (51.8% of all isolates), 154 as Streptococcus pneumoniae (30.4%), 60 as Moraxella catarrhalis (11.9%) and 30 as Staphylococcus aureus (5.9%). All strains were analysed according to their susceptibility to a wide set of antimicrobial agents by the broth microdilution method. Ten H. influenzae strains (3.8%) were identified as ampicillin-resistant, beta-lactamase-positive. In 6 other isolates (2.3%) lowered susceptibility to ampicillin without beta-lactamase production was detected, which may be indicate that these are ampicillin-resistant, beta-lactamase-negative (BLNAR) H. influenzae. Twenty two Streptococcus pneumoniae isolates (14.3%) were identified as penicillin non-susceptible pneumococci (PNSP). In this group of pneumococcal isolates, multi-drug resistance was observed. Among PNSP, only 18.2% were susceptible to doxycycline, 27.3% to co-trimoxazole, 36.4% to erythromycin, and 68.8% to chloramphenicol. Twelve (7.8%) PNSP isolates have been identified as intermediately susceptible to penicillin (MIC ranging from 0.12 to 1 mg/l) and all were susceptible to amoxicillin. Over 80% of M. catarrhalis and S. aureus isolates were beta-lactamase positive. Of the antimicrobial agents analysed over 90% of isolates were identified as being susceptible to ceftriaxone, amoxicillin with clavulanic acid, cefuroxime, ciprofloxacin and ofloxacin.
The Alexander Project is organised and funded by SmithKline Beecham.

Keywords: Alexander Project, lower respiratory tract infections, antibiotic resistance