title: Association of penicillin-resistant pneumococci with residence in a pediatric chronic care facility.
abstract: Risk factors for the acquisition of penicillin-resistant pneumococci (PRP) were analyzed at a university hospital in New York City. Patients with PRP and control patients with penicillin-sensitive pneumococcal infections were compared. In 1994, 24 (21%) of 113 patients with Streptococcus pneumoniae infections had PRP; 13 PRP isolates were from children and 11 from adults. Only white race (P < .05) and residence in a pediatric chronic care facility (P < .05) were significantly associated with penicillin resistance. An investigation at one chronic care facility revealed that 33% of children (17/52) had PRP colonization. Fourteen of the 17 PRP isolates were also resistant to ceftriaxone. Prior antibiotic use and specifically beta-lactam use were associated with penicillin resistance. All typeable PRP isolates were multidrug-resistant serotype 23. Pediatric residents in chronic care facilities may be an important reservoir of PRP and may serve as a source of PRP transmission when they are transferred to acute care hospitals.
authors.affiliation: Department of Medicine, New York Hospital-Cornell Medical Center, New York, NY 10021, USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Mannheimer
authors.forename: L W
authors.initials: LW
authors.lastname: Riley
authors.forename: R B
authors.initials: RB
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D005260:Female; D006763:Hospitals, Chronic Disease; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use*; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000208:ethnology; D012307:Risk Factors
chemical_list: D010406:Penicillins