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Antimicrobial resistance with Streptococcus pneumoniae in the United States, 1997 98
G V Doern1, A B Brueggemann, H Huynh
1Department of Pathology, University of Iowa College of Medicine, Iowa City 52242, USA. gary-doern@uiowa.edu
Abstract:
From November 1997 to April 1998, 1,601 clinical isolates of Streptococcus pneumoniae were obtained from 34 U.S. medical centers. The overall rate of strains showing resistance to penicillin was 29. 5%, with 17.4% having intermediate resistance. Multidrug resistance, defined as lack of susceptibility to penicillin and at least two other non-ss-lactam classes of antimicrobial drugs, was observed in 16.0% of isolates. Resistance to all 10 ss-lactam drugs examined in this study was directly related to the level of penicillin resistance. Penicillin resistance rates were highest in isolates from middle ear fluid and sinus aspirates of children ambulatory-care settings. Twenty-four of the 34 medical centers in this study had participated in a similar study 3 years before. In 19 of these 24 centers, penicillin resistance rates increased 2.9% to 39.2%. Similar increases were observed with rates of resistance to other antimicrobial drugs.
Insights
Penicillin resistance in Streptococcus pneumoniae is a growing concern, with nearly 30% of strains resistant. Multidrug resistance is also prevalent, particularly in pediatric infections, indicating a need for updated treatment strategies.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Streptococcus pneumoniae is a leading cause of bacterial infections worldwide.
- Antimicrobial resistance in S. pneumoniae poses a significant public health threat.
- Previous studies have indicated rising resistance rates, necessitating ongoing surveillance.
Purpose of the Study:
- To determine the prevalence of penicillin and multidrug resistance in clinical isolates of Streptococcus pneumoniae.
- To identify trends in antimicrobial resistance over a three-year period.
- To investigate the relationship between penicillin resistance and resistance to other antimicrobial agents.
Main Methods:
- Collection of 1,601 clinical isolates of Streptococcus pneumoniae from 34 U.S. medical centers between November 1997 and April 1998.
- Susceptibility testing for penicillin and nine other antimicrobial drugs.
- Definition and assessment of multidrug resistance based on non-β-lactam drug classes.
Main Results:
- An overall penicillin resistance rate of 29.5% was observed, with 17.4% exhibiting intermediate resistance.
- Multidrug resistance was found in 16.0% of isolates.
- Penicillin resistance was highest in isolates from pediatric middle ear fluid and sinus aspirates.
- A significant increase in penicillin resistance rates was noted in centers that participated in a previous study three years prior.
- Similar increasing trends were observed for resistance to other antimicrobial drugs.
Conclusions:
- Penicillin resistance in Streptococcus pneumoniae remains high and is increasing in many U.S. medical centers.
- Multidrug resistance is a significant issue, particularly in pediatric infections.
- The findings underscore the importance of continued surveillance and the need to monitor antimicrobial resistance patterns to guide effective treatment strategies.