A. Pikis et al., PENICILLIN-RESISTANT PNEUMOCOCCI FROM PEDIATRIC-PATIENTS IN THE WASHINGTON, DC, AREA, Archives of pediatrics & adolescent medicine, 149(1), 1995, pp. 30-35
Objective: To assess the prevalence and antimicrobial susceptibility o
f penicillin-resistant pneumococci (PRP) isolated from patients in a p
ediatric hospital. Methods: All (108) isolates of Streptococcus pneumo
niae recovered from usually sterile body sites between June 1, 1992, a
nd May 31, 1993, were screened for susceptibility to penicillin by the
E-test method. Minimum inhibitory concentrations of penicillin and ot
her antibiotics were also determined by an agar dilution method for 10
PRP and 22 penicillin-susceptible strains. Results: Fourteen isolates
(12.9%) were PRP by the E-test; nine of these (8.3%) were intermediat
ely resistant and five (4.6%) were highly resistant. All strains were
sensitive to rifampin and vancomycin. Increased frequency of resistanc
e to oral and parenteral cephalosporins and carbapenems was found amon
g PRP; for most of these antibiotics, resistance exceeded 40% of the P
RP. In addition, 20% of the PRP were resistant to macrolides and all p
enicillin-susceptible and PRP were resistant to a combination of trime
thoprim and sulfamethoxazole. Conclusions: The decreased susceptibilit
y to oral and parenteral cephalosporins, macrolides, a combination of
trimethoprim and sulfamethoxazole, and carbapenems creates a significa
nt problem in the treatment of pneumococcal infections in bath ambulat
ory and hospitalized patients.