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Nosocomial penicillin-resistant pneumococcal infections at a Midwestern university hospital

J R Little1, J Miller, M G Kahn

  • 1Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO 63110-1093, USA.

Infection Control and Hospital Epidemiology
|November 4, 1998
PubMed

Insights

Penicillin resistance in Streptococcus pneumoniae (S pneumoniae) is significant in adult inpatients. Nosocomial S pneumoniae infections showed higher penicillin resistance compared to community-acquired infections.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Hospital Epidemiology

Background:

  • Streptococcus pneumoniae is a leading cause of bacterial pneumonia and other invasive infections in adults.
  • Antimicrobial resistance, particularly to commonly prescribed antibiotics like penicillin and ceftriaxone, is a growing public health concern.
  • Understanding the prevalence and characteristics of S pneumoniae infections in hospital settings is crucial for effective treatment and infection control.

Purpose of the Study:

  • To determine the prevalence of antibiotic resistance in Streptococcus pneumoniae isolates from adult inpatients.
  • To compare the rates of penicillin resistance between nosocomial and community-acquired S pneumoniae infections.
  • To assess the susceptibility patterns of S pneumoniae to ceftriaxone.

Main Methods:

  • Analysis of 333 Streptococcus pneumoniae isolates from adult inpatients over 30 months.
  • Determination of penicillin and ceftriaxone resistance rates.
  • Classification of infections as nosocomial or community-acquired based on isolation time and chart review.

Main Results:

  • Twenty-five percent of all S pneumoniae isolates were resistant to penicillin.
  • Eighteen percent of tested strains showed reduced susceptibility to ceftriaxone.
  • Penicillin resistance was significantly higher in nosocomial S pneumoniae infections (48.3%) compared to community-acquired infections (20.0%), with an odds ratio of 3.73 (P=.01).

Conclusions:

  • A substantial proportion of adult inpatient Streptococcus pneumoniae isolates exhibit penicillin resistance.
  • Nosocomial S pneumoniae infections are associated with a significantly higher risk of penicillin resistance.
  • Continued surveillance of antimicrobial resistance patterns is essential for guiding antibiotic therapy and infection control strategies in hospitals.

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