Rj. Stanek et Ma. Mufson, EMERGENCE OF PENICILLIN-RESISTANT INVASIVE PNEUMOCOCCI IN A SINGLE AMERICAN COMMUNITY, The American journal of the medical sciences, 310(4), 1995, pp. 150-155
Three decades ago, penicillin-resistant strains of Streptococcus pneum
oniae were first reported. Since then, myriad penicillin resistant str
ains of S. pneumoniae have been identified worldwide and in the United
States. No resistant or intermediate resistant strains have been repo
rted in West Virginia because testing has not been done. Between 1983
and 1994, the authors' surveillance of invasive pneumococcal disease i
n metropolitan Huntington, West Virginia, identified 356 pneumococcal
strains from blood and other usually sterile sites, including 110 stra
ins belonging to serotypes 6, 9, 14, 19, and 23, the main serotypes ex
hibiting penicillin resistance. The authors tested these serotypes for
penicillin susceptibility by the E-test. Sixteen (14.5%) strains of t
ypes 6, 9, 14, 19, and 23 exhibited intermediate resistance to penicil
lin. No highly resistant strains were identified. Most of the intermed
iate resistant strains of types 9, 14, and 23 were detected in epidemi
ologic years 1992-1994. The increasing resistant penicillin strains si
gnals the need for routine testing of invasive pneumococcal strains fo
r penicillin susceptibility and necessitates appropriate antibiotic us
age.