THE CONTINUED EMERGENCE OF DRUG-RESISTANT STREPTOCOCCUS-PNEUMONIAE INTHE UNITED-STATES - AN UPDATE FROM THE CENTERS-FOR-DISEASE-CONTROL AND PREVENTIONS PNEUMOCOCCAL SENTINEL SURVEILLANCE SYSTEM

As part of ongoing national surveillance, serotyping and antimicrobial susceptibility testing were done on all pneumococcal isolates recover ed from normally sterile body sites of patients at 12 hospitals in 11 states during 1993-1994. Of 740 isolates, 14.1% were penicillin-nonsus ceptible Streptococcus pneumoniae (PNSP; MIC greater than or equal to 0,1 mu g/mL), 3.2% were penicillin-resistant (MIC greater than or equa l to 2.0 mu g/mL), and 25.5% were nonsusceptible to more than one anti microbial agent. PNSP were more prevalent among children <6 years old (18.4%) than patients greater than or equal to 18 years old (11.7%) an d among white persons (16.2%) than black persons (12.1%). PNSP represe nted 15 serotypes, but 89% of PNSP were serotypes in the 23-valent pne umococcal vaccine, The proportion of isolates with reduced susceptibil ity and the number of serotypes of nonsusceptible strains are increasi ng in the United States. Improved local surveillance for PNSP infectio ns,judicious use of antibiotics, and development and use of effective pneumococcal vaccines will be required to treat and prevent disease ca used by these strains.