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Increasing frequency of penicillin-resistant pneumococci: epidemiological aspects and case-control study
Israel Journal of Medical Sciences
|April 1, 1985
Summary
The frequency of penicillin-resistant pneumococci increased significantly in children from 1979-82. Increased beta-lactam antibiotic use in general practice may contribute to the emergence of these resistant strains.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- The prevalence of penicillin-resistant pneumococci (RPRP) has been a growing concern.
- An increase in RPRP isolates was observed at Hadassah University Hospital between 1979 and 1982.
Purpose of the Study:
- To investigate the rise in RPRP isolates.
- To identify risk factors associated with RPRP, particularly antibiotic usage patterns.
Main Methods:
- Retrospective analysis of RPRP isolate frequency from 1979-1982.
- Disk sensitivity and minimal inhibitory concentration (MIC) testing for penicillin resistance.
- Case-control study examining antibiotic usage in the 60 days prior to pneumococcal isolation.
Main Results:
- RPRP isolate frequency rose from 0.9% to 10.8%, with a notable impact on infants and children (<14 years).
- MIC values confirmed penicillin G resistance in RPRP isolates (0.25-0.50 µg/ml).
- Case-control study revealed significantly higher beta-lactam antibiotic usage (13.3 days) in RPRP patients compared to controls (4.2 days).
Conclusions:
- General antibiotic prescribing practices, especially beta-lactam use, may drive the emergence of RPRP strains.
- Pediatric populations are particularly vulnerable to the increasing prevalence of RPRP.
- Prudent antibiotic stewardship is crucial to mitigate the spread of antibiotic resistance.