Resistance to penicillin and non-beta-lactam antibiotics of Streptococcus pneumoniae at a children's hospital.
During a 12-month period we tested all isolates of Streptococcus pneumoniae recovered from patients at St. Louis Children's Hospital for resistance to penicillin and other antibiotics. Twenty-seven (20%) of 136 had relative penicillin resistance (minimum inhibitory concentration 0.1 to 1.0 microgram/ml) and 8 (6%) were fully resistant (minimum inhibitory concentration > or = 2.0 micrograms/ml). Sixteen percent from blood and cerebrospinal fluid were resistant, compared with 30% from other body sites. The resistant isolates were of diverse serotypes and included 38% intermediate and 6% resistant to cefotaxime, 40% resistant to trimethoprim-sulfamethoxazole and 20% resistant to erythromycin. Patients with resistant isolates were more likely to have taken antibiotics of the aminopenicillin class and to be of the white race. We conclude that penicillin-resistant pneumococci, including some with resistance to third generation cephalosporins and some with multidrug resistance to non-beta-lactam antibiotics, are widespread in the St. Louis area. The presence of these stains requires reconsideration of current approaches to the antibiotic therapy of a variety of infectious diseases in which pneumococci play a prominent role.
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110.
P L
PL
Welby
D S
DS
Keller
J L
JL
Cromien
P
P
Tebas
G A
GA
Storch
D004352:Drug Resistance, Microbial / Q000502:physiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance / Q000502:physiology; D012703:Serotyping; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects*