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Streptococcus pneumoniae bacteremia: duration of previous antibiotic use and association with penicillin resistance

Jörg J Ruhe1, Rodrigo Hasbun

  • 1Department of Medicine, Infectious Diseases Section, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|April 26, 2003
PubMed

Insights

Previous antibiotic exposure increases the risk of penicillin-nonsusceptible Streptococcus pneumoniae (PNSP) infection. Beta-lactam and macrolide use in the 6 months prior significantly elevates PNSP bacteremia risk.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Previous antibiotic exposure is a key predictor for acquiring penicillin-nonsusceptible Streptococcus pneumoniae (PNSP) infections.
  • Understanding the impact of antibiotic class and duration on PNSP acquisition is crucial for infection control.

Purpose of the Study:

  • To investigate the association between antibiotic exposure duration and class with PNSP bacteremia.
  • To identify specific antibiotic classes and exposure durations that increase the risk of PNSP infection.

Main Methods:

  • Retrospective study of 303 patients with Streptococcus pneumoniae bacteremia.
  • Analysis of antibiotic use within 1 and 6 months prior to positive blood cultures.
  • Bivariate and logistic regression analyses to determine risk factors for PNSP bacteremia.

Main Results:

  • 32% of bacteremia cases (98/303) were caused by PNSP.
  • Use of beta-lactams, sulfonamides, and macrolides within 6 months was associated with PNSP bacteremia (P<.05).
  • Both short- and long-term beta-lactam use, and macrolide use in the 6 months prior, were independent risk factors for PNSP infection.

Conclusions:

  • Antibiotic class and duration of exposure are critical factors in the risk of acquiring PNSP infection.
  • Beta-lactams and macrolides are significant risk factors for PNSP bacteremia.
  • Targeted antibiotic stewardship interventions based on exposure history are warranted.

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