Resistance to penicillin and non-beta-lactam antibiotics of Streptococcus pneumoniae at a children's hospital

P. L. Welby, D. S. Keller, J. L. Cromien, P. Tebas, G. A. Storch

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Abstract

During a 12-month period we tested all isolates of Streptococcus pneumoniae recovered from patients at St. Louis Children's Hospital for resistance to penicillin and other antibiotics. Twenty-seven (20%) of 136 had relative penicillin resistance (minimum inhibitory concentration 0.1 to 1.0 μg/ml) and 8 (6%) were fully resistant (minimum inhibitory concentration ≥2.0 μg/ml). Sixteen percent from blood and cerebrospinal fluid were resistant, compared with 30% from other body sites. The resistant isolates were of diverse serotypes and included 38% intermediate and 6% resistant to cefotaxime, 40% resistant to trimethoprim-sulfamethoxazole and 20% resistant to erythromycin. Patients with resistant isolates were more likely to have taken antibiotics of the aminopenicillin class and to be of the white race. We conclude that penicillin-resistant pneumococci, including some with resistance to third generation cephalosporins and some with multidrug resistance to non-beta-lactam antibiotics, are widespread in the St. Louis area. The presence of these stains requires reconsideration of current approaches to the antibiotic therapy of a variety of infectious diseases in which pneumococci play a prominent role.

Original languageEnglish
Pages (from-to)281-287
Number of pages7
JournalPediatric Infectious Disease Journal
Volume13
Issue number4
StatePublished - Jan 1 1994

Keywords

  • Streptococcus pneumoniae
  • antibiotic resistance
  • cephalosporins
  • penicillin
  • pneumococcus

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