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Invasive pneumococcal disease in central Oklahoma: emergence of high-level penicillin resistance and multiple

L A Haglund1, G R Istre, D A Pickett

  • 1Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City.

The Journal of Infectious Diseases
|December 1, 1993
PubMed

Insights

Antibiotic resistance in invasive pneumococcal disease is a growing concern. This study in Oklahoma found significant rates of penicillin and other antibiotic resistance in pneumococcal infections.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Invasive pneumococcal disease (IPD) remains a significant public health concern.
  • Understanding antibiotic resistance patterns is crucial for effective treatment and prevention strategies.
  • Previous data from central Oklahoma indicated low levels of high-level antibiotic resistance in pneumococci.

Purpose of the Study:

  • To evaluate the antibiotic susceptibility and serotype distribution of invasive pneumococcal disease (IPD) in the Oklahoma City metropolitan area.
  • To determine the prevalence of antibiotic resistance in *Streptococcus pneumoniae* isolates causing IPD.
  • To assess IPD rates in different demographic groups, including the elderly and nursing home residents.

Main Methods:

  • A prospective study collected 144 cases of IPD over one year in the Oklahoma City metropolitan area.
  • Antibiotic susceptibility testing was performed on *Streptococcus pneumoniae* isolates.
  • Demographic data, including age and residency (nursing home vs. non-resident), were collected to calculate disease rates.

Main Results:

  • The overall incidence of IPD was 16.9 cases per 100,000 population.
  • Antibiotic-resistant organisms accounted for 19.4% of IPD cases.
  • Relative penicillin resistance was observed in 7.6% of isolates, with high-level penicillin resistance in 1.4%. Resistance to erythromycin and/or trimethoprim-sulfamethoxazole was 11%, with 5% exhibiting dual resistance.
  • IPD rates were substantially higher in nursing home residents (352/100,000) compared to non-residents (25.6/100,000) in the elderly population (≥60 years).

Conclusions:

  • Antibiotic resistance, particularly relative penicillin resistance, is present in invasive pneumococcal disease in Oklahoma City.
  • The findings highlight the need for ongoing surveillance of antibiotic resistance patterns in *Streptococcus pneumoniae*.
  • Targeted prevention and treatment strategies may be necessary for high-risk populations like elderly nursing home residents.

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