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Penicillin-Resistant Pneumococci From Pediatric Patients in the Washington, DC, Area

Andreas Pikis, MD; Shama Akram, MS; Jacob A. Donkersloot, ScD; Joseph M. Campos, PhD; William J. Rodriguez, MD, PhD
Arch Pediatr Adolesc Med. 1995;149(1):30-35. doi:10.1001/archpedi.1995.02170130032007.
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Objective:  To assess the prevalence and antimicrobial susceptibility of penicillin-resistant pneumococci (PRP) isolated from patients in a pediatric hospital.

Methods:  All (108) isolates of Streptococcus pneumoniae recovered from usually sterile body sites between June 1, 1992, and May 31, 1993, were screened for susceptibility to penicillin by the E-test method. Minimum inhibitory concentrations of penicillin and other antibiotics were also determined by an agar dilution method for 10 PRP and 22 penicillin-susceptible strains.

Results:  Fourteen isolates (12.9%) were PRP by the E-test; nine of these (8.3%) were intermediately resistant and five (4.6%) were highly resistant. All strains were sensitive to rifampin and vancomycin. Increased frequency of resistance to oral and parenteral cephalosporins and carbapenems was found among PRP; for most of these antibiotics, resistance exceeded 40% of the PRP. In addition, 20% of the PRP were resistant to macrolides and all penicillin-susceptible and PRP were resistant to a combination of trimethoprim and sulfamethoxazole.

Conclusions:  The decreased susceptibility to oral and parenteral cephalosporins, macrolides, a combination of trimethoprim and sulfamethoxazole, and carbapenems creates a significant problem in the treatment of pneumococcal infections in both ambulatory and hospitalized patients.(Arch Pediatr Adolesc Med. 1995;149:30-35)

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