title: Penicillin and vancomycin tolerance among clinical isolates of Streptococcus pneumoniae in Hong Kong.
abstract: OBJECTIVE
  To determine the prevalence of penicillin and vancomycin tolerance in clinical isolates of Streptococcus pneumoniae.
  
  
  METHODS
  Laboratory testing of 50 consecutive clinical isolates.
  
  
  METHODS
  District hospital, Hong Kong.
  
  
  METHODS
  Fifty patients with pneumonia or meningitis who were admitted to a district hospital in Hong Kong between August and October 2002.
  
  
  METHODS
  Lysis, as assessed by loss of optical density at 4 hours at 540 nm, and reduction in viable count expressed as the log of the number killed ('log kill') after exposure of cultures to 10 times the minimum inhibitory concentration of penicillin and vancomycin.
  
  
  RESULTS
  Of the 50 isolates, five (10%) were tolerant to penicillin and one (2%) was tolerant to vancomycin.
  
  
  CONCLUSIONS
  This is the first report of vancomycin tolerance in Streptococcus pneumoniae in Hong Kong. Because vancomycin tolerance is associated with clinical failure in the treatment of pneumococcal meningitis, increased monitoring for resistant strains of organisms is suggested.
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. hsmboost@inet.polyu.edu.hk
authors.forename: M V
authors.initials: MV
authors.lastname: Boost
authors.forename: W M
authors.initials: WM
authors.lastname: Ko
authors.forename: M M
authors.initials: MM
authors.lastname: O'Donoghue
mesh_terms: D004361:Drug Tolerance; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000494:pharmacology*; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D014640:Vancomycin / Q000494:pharmacology*; D020713:Vancomycin Resistance
chemical_list: D010406:Penicillins; D014640:Vancomycin