Emergence of multiply resistant pneumococci

Multiple antimicrobial resistance in pneumococci was detected in Johannesburg in July, 1977, and prompted an investigation of the prevalence of resistant strains in two hospitals. Carriers of Types 6A and 19A penicillin-resistant pneumococci, resistant to antibiotic concentrations ranging between 0....

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Bibliographic Details
Published in:	The New England journal of medicine Vol. 299; no. 14; p. 735
Main Authors:	Jacobs, M R, Koornhof, H J, Robins-Browne, R M, Stevenson, C M, Vermaak, Z A, Freiman, I, Miller, G B, Witcomb, M A, Isaäcson, M, Ward, J I, Austrian, R
Format:	Journal Article
Language:	English
Published:	United States 05-10-1978
Subjects:	Adult Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Carrier State - drug therapy Carrier State - epidemiology Carrier State - microbiology Child, Preschool Drug Resistance, Microbial Humans Male Microbial Sensitivity Tests - methods Pneumococcal Infections - drug therapy Pneumococcal Infections - epidemiology Pneumococcal Infections - microbiology South Africa Streptococcus pneumoniae - drug effects Streptococcus pneumoniae - isolation & purification South Africa
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Summary:	Multiple antimicrobial resistance in pneumococci was detected in Johannesburg in July, 1977, and prompted an investigation of the prevalence of resistant strains in two hospitals. Carriers of Types 6A and 19A penicillin-resistant pneumococci, resistant to antibiotic concentrations ranging between 0.12 and 4 microgram per milliliter were found in 29 per cent of 543 pediatric patients and 2 per cent of 434 hospital staff members. Multiply resistant Type 19A strains, resistant to beta-lactam antibiotics, erythromycin, clindamycin, tetracycline and chloramphenicol, were isolated from 128 carriers, and were responsible for bacteremia in four patients. Isolates from 40 other carriers were resistant to penicillin alone or to penicillin and chloramphenicol or to penicillin, chloramphenicol and tetracycline. Pneumococci can be screened for penicillin resistance with a modified Kirby--Bauer technic; the strains with zones of less than 35 mm around 6-microgram penicillin disks or less than 25 mm around 5-microgram methicillin disks should be tested for sensitivity to penicillin by measurements of minimum inhibitory concentration.
ISSN:	0028-4793
DOI:	10.1056/NEJM197810052991402