PENICILLIN-RESISTANT PNEUMOCOCCI FROM PEDIATRIC-PATIENTS IN THE WASHINGTON, DC, AREA

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.