Prevalence of penicillin-nonsusceptible pneumococcal bacteremia in a Staten Island community hospital

Background. Although the first reports of infection due to penicillin-nonsu sceptible Streptococcus pneumoniae in the United States were in children, t hese strains have circulated widely in recent years, with the prevalence in creasing dramatically among the elderly. Regional surveillance of pneumococ cal susceptibility profiles may assist clinicians in management decisions, increase awareness of this microbial threat, and target potential areas of intervention. Methods. As part of ongoing surveillance, we surveyed single-patient pneumo coccal blood isolates in our 440-bed Staten Island community teaching hospi tal from June 1, 1996, through May 31, 1998. Results. Overall, of 47 single-patient isolates, 16 (35%) were penicillin n onsusceptible. Of 35 isolates from adults, 15 (44%) were nonsusceptible, co mpared with 1 of 12 (8%) from children. Seven of the nonsusceptible isolate s (44%) were from persons greater than or equal to 65 years old and represe nted 47% of the isolates from this age group. Conclusions. Community-acquires penicillin-nonsusceptible pneumococcal bact eremia is not simply a pediatric problem, but also a threat to the elderly.