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December 10, 1982

Sulfamethoxazole-Trimethoprim-Resistant Pneumococcal Sepsis

Author Affiliations

From the Bone Marrow Transplant Unit, The Johns Hopkins Oncology Center (Drs Markham, Mannisi, Santos, and Saral), and the Division of Laboratory Medicine (Mr Dick and Ms Filburn), The Johns Hopkins University School of Medicine, Baltimore.

JAMA. 1982;248(22):3011-3012. doi:10.1001/jama.1982.03330220055038

THE SUCCESS of bone marrow transplantation in the treatment of aplastic anemia and acute leukemia has resulted in an increasingly large number of long-term survivors of this procedure.

The occurrence of infections in these patients has been recognized as a major cause of morbidity and mortality, particularly in those patients in whom chronic graft-v-host disease develops.1Streptococcus pneumoniae has been noted to cause a substantial portion of the reported infections,1,2 and it has been suggested that immunization with polyvalent pneumococcal vaccine and long-term antibiotic prophylaxis be used to prevent this complication.2

Reports of pneumococci both resistant to penicillin in vitro and producing clinically important infection have been a cause of great concern.3 While some of these organisms have been found to be resistant to sulfamethoxazole-trimethoprim as well as penicillin,3 there have been, to our knowledge, no reports of penicillin-sensitive/sulfamethoxazole-trimethoprim-resistant pneumococci causing clinical infection. We report