January 1995

Penicillin-Resistant Pneumococci From Pediatric Patients in the Washington, DC, Area

Author Affiliations

From the Departments of Infectious Diseases (Drs Pikis and Rodriguez), Microbiology Research, The Research Foundation (Ms Akram), and Laboratory Medicine (Dr Campos), Children's National Medical Center, Washington, DC; the Laboratory of Microbial Ecology (Drs Pikis and Donkersloot), National Institute of Dental Research, National Institutes of Health, Bethesda, Md; and the Departments of Pediatrics, Pathology, and Microbiology/Immunology (Dr Campos), George Washington University Medical Center, Washington, DC.

Arch Pediatr Adolesc Med. 1995;149(1):30-35. doi:10.1001/archpedi.1995.02170130032007

Objective:  To assess the prevalence and antimicrobial susceptibility of penicillin-resistant pneumococci (PRP) isolated from patients in a pediatric hospital.

Methods:  All (108) isolates of Streptococcus pneumoniae recovered from usually sterile body sites between June 1, 1992, and May 31, 1993, were screened for susceptibility to penicillin by the E-test method. Minimum inhibitory concentrations of penicillin and other 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 intermediately resistant and five (4.6%) were highly resistant. All strains were sensitive to rifampin and vancomycin. Increased frequency of resistance to oral and parenteral cephalosporins and carbapenems was found among PRP; for most of these antibiotics, resistance exceeded 40% of the PRP. In addition, 20% of the PRP were resistant to macrolides and all penicillin-susceptible and PRP were resistant to a combination of trimethoprim and sulfamethoxazole.

Conclusions:  The decreased susceptibility to oral and parenteral cephalosporins, macrolides, a combination of trimethoprim and sulfamethoxazole, and carbapenems creates a significant problem in the treatment of pneumococcal infections in both ambulatory and hospitalized patients.(Arch Pediatr Adolesc Med. 1995;149:30-35)