PENICILLIN-NONSUSCEPTIBLE AND CEPHALOSPORIN-NONSUSCEPTIBLE STREPTOCOCCUS-PNEUMONIAE - A POPULATION-BASED STUDY IN DALLAS COUNTY, TEXAS

I The prevalence of invasive disease caused by penicillin-nonsusceptib le Streptococcus pneumoniae (PNSP) in 1992 and 1993 was determined for residents of Dallas County, Texas, through population-based surveilla nce. S. pneumoniae were isolated from sterile sites of 725 eligible pa tients who had 732 episodes. In strains from 502 patients, the prevale nces of PNSP and penicillin-resistant S. pneumoniae were 14% and 3%, r espectively; the prevalence of nonsusceptibility to cefotaxime was 5%. Nonsusceptibility to seven oral antibiotics paralleled the level of n onsusceptibility to penicillin. Nonsusceptibility to penicillin and to cefotaxime was higher in children <5 years of age than in older patie nts (P less than or equal to .03). The prevalence of PNSP in pediatric patients estimated from surveillance of the population was significan tly higher than was previously estimated from surveillance at the majo r pediatric hospital. Population-based surveillance offers a more reli able method for assessing the prevalence of PNSP as a basis for develo ping recommendations for empiric therapy.