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Relative resistance to penicillin in the pneumococcus. A prevalence and case-control study
Abstract:
Isolates of Streptococcus pneumoniae from 103 patients were submitted for serotyping and determination of the minimum inhibitory concentration (MIC) for penicillin. Isolates from 16 patients were relatively resistant to penicillin (MIC, 0.1 to 0.5 micrograms/mL). In a study to determine if the patients with relatively resistant pneumococci (RRP) differed from patients with normally susceptible pneumococci, 18 patients with RRP showed no significant difference from their matched controls in antibiotic use during the two months prior to isolation of the pneumococcus. Other variables that showed no significant difference between the two groups were (1) antibiotic use in household contacts in the previous six months, (2) presence of chronic infection in the case or control patients, and (3) recurrence of pneumococcal infection following therapy. The high rate of relative resistance to penicillin is heretofore unknown in a general, unconfined population in this country. The case-control study suggests that no strong relationship exists between isolating RRP and prior penicillin administration. More extensive surveys in the United States are needed.
Insights
A study found that 16 out of 103 patients had penicillin-resistant Streptococcus pneumoniae. No strong link was found between this resistance and prior penicillin use in a case-control study.
Area of Science:
- * Clinical microbiology and infectious diseases.
- * Antimicrobial resistance surveillance.
- * Public health epidemiology.
Background:
- * Streptococcus pneumoniae is a common cause of bacterial infections.
- * Penicillin resistance in S. pneumoniae is a growing public health concern.
- * Understanding risk factors for penicillin resistance is crucial for effective treatment.
Purpose of the Study:
- * To determine the prevalence of penicillin resistance in Streptococcus pneumoniae isolates.
- * To investigate potential associations between penicillin resistance and patient/household factors.
- * To assess the relationship between prior penicillin administration and the isolation of relatively penicillin-resistant pneumococci (RRP).
Main Methods:
- * Serotyping and determination of minimum inhibitory concentration (MIC) for penicillin were performed on S. pneumoniae isolates from 103 patients.
- * A case-control study compared 18 patients with RRP to matched controls.
- * Variables assessed included prior antibiotic use (patient and household), chronic infection, and infection recurrence.
Main Results:
- * Sixteen of 103 isolates (approximately 15.5%) exhibited relative resistance to penicillin (MIC, 0.1 to 0.5 µg/mL).
- * No significant differences were found between RRP patients and controls regarding prior antibiotic use, chronic infections, or infection recurrence.
- * The study found no strong relationship between isolating RRP and prior penicillin administration.
Conclusions:
- * A notable rate of penicillin-relative resistance in Streptococcus pneumoniae was observed in a general population, which is previously undocumented.
- * The findings suggest that prior penicillin administration is not a strong predictor for isolating RRP.
- * Further extensive surveys are recommended to monitor antimicrobial resistance trends in the United States.