EMERGENCE OF PENICILLIN-RESISTANT INVASIVE PNEUMOCOCCI IN A SINGLE AMERICAN COMMUNITY

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.