The Prevalence of Drug-ResistantStreptococcus pneumoniaeIn Atlanta

作者：Jo Hofmann, Martín S. Cetron, Monica M. Farley, Wendy Baughman, Richard R. Facklam, John A. Elliott, K.A. Deaver, Robert F. Breiman · 发表于：New England Journal of Medicine · 年份：1995 · DOI：10.1056/nejm199508243330803 · 被引用次数：508 · 研究领域：Pneumonia and Respiratory Infections、Antibiotics Pharmacokinetics and Efficacy、Streptococcal Infections and Treatments

BACKGROUND: Streptococcus pneumoniae is a major cause of illness, and the emergence of drug-resistant strains threatens to complicate the management of pneumococcal infections. We conducted a laboratory-based surveillance for drug-resistant S. pneumoniae among patients with invasive pneumococcal infections in Atlanta. METHODS: From January through October 1994, pneumococcal isolates from 431 patients with invasive disease in metropolitan Atlanta were serotyped and tested to determine their susceptibility to various antimicrobial agents. Susceptibility to the antimicrobial agents was defined according to guidelines established by the National Committee for Clinical Laboratory Standards. RESULTS: The annual incidence of invasive pneumococcal infection was 30 cases per 100,000 population. Isolates from 25 percent of the patients were resistant to penicillin (7 percent were highly resistant), and isolates from 26 percent were resistant to trimethoprim-sulfamethoxazole (7 percent highly resistant). Fifteen percent of the isolates were resistant to erythromycin, 9 percent to cefotaxime (4 percent were highly resistant), and 25 percent to multiple drugs. Drug-resistant pneumococci were found in both children and adults. Children under six years of age were more likely than older children and adults to have isolates resistant to multiple drugs or cefotaxime. Whites were more likely than blacks to have invasive pneumococcal infections caused by drug-resistant organisms. Among white ch...