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June 15, 1994

Drug-Resistant Pneumococcal Infections in the United States: A Problem for Clinicians, Laboratories, and Public Health

JAMA. 1994;271(23):1875-1876. doi:10.1001/jama.1994.03510470079039

Drug-resistant Streptococcus pneumoniae (DRSP) strains were once considered to be laboratory curiosities1,2 or problems for far-off areas of the world.3-5 In the United States, however, pneumococci that were relatively resistant to penicillin (minimum inhibitory concentration, 0.12 to 1.0 μg/mL) were found among the isolates from Navajo Indians living in New Mexico in 1974,6 and a serotype 14 S pneumoniae isolate with high-level resistance to penicillin (minimum inhibitory concentration, ≥2.0 μg/mL) was recovered from the blood of an immunocompromised child from Minnesota in 1977.7 Since these initial reports, foci of DRSP have been identified in various parts of this country.8-12 The reports from the Centers for Disease Control and Prevention from Kentucky and Tennessee,13 from Connecticut,14 and by Breiman et al15 in this issue of The JOURNAL are alarming because they prove that DRSP isolates can now be found in unselected, diverse sites