Penicillin-resistant Streptococcus pneumoniae in metropolitan New York hospitals: Case control study and molecular typing of resistant isolates

R. B. Roberts, A. Tomasz, A. Corso, J. Hargrave, E. Severina, V. LaBombardi, A. Sampath, S. Mannheimer, G. Pringle, J. Rahal, C. Urban, B. Currie, J. Bartscher, M. Levi, J. Berger, S. Brown, A. Shahidi, R. Leggiadro, M. Hashem, V. KopetzE. Spitzer, K. Van Horn, D. Larone

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Abstract

During the 4-month period from January to April, 1998, 476 patients with Streptococcus pneumoniae infections were detected in 12 metropolitan New York hospitals and 112 penicillin-resistant (PRP) isolates (24%) were identified in 11 institutions. A case control study of 100 patients with penicillin-resistant and susceptible pneumococci from four of the widely dispersed hospitals revealed a high incidence of underlying medical illnesses in adult patients (74%), a preponderance of patients with pneumonia (63%), and a majority of patients who had underlying risk factors for pneumonia or invasive disease (51%). In this limited case control study, no difference was noted between cases and controls regarding known risk factors for penicillin-resistant pneumococcal infections. The percentage of single-patient PRP isolates varied among individual hospitals but the mean percentages of PRP from the four participating University Medical Centers and seven community hospitals were similar: 26% and 22% respectively. By E-test, 60% and 26% were high-level penicillin and ceftriaxone resistant, respectively. Pulsed-field gel electrophoresis identified 26 chromosomal macrorestriction patterns among the 103 PRP isolates available for analysis, but almost half (50 isolates or 48%) of these belong to two drug-resistant internationally spread clones, SP23-1 and Sp9/14-3, that were detected in all hospitals and were recovered from invasive and noninvasive sites in both children and adults.

Original languageEnglish (US)
Pages (from-to)137-152
Number of pages16
JournalMicrobial Drug Resistance
Volume7
Issue number2
DOIs
Publication statusPublished - Jan 1 2001

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ASJC Scopus subject areas

  • Microbiology
  • Immunology
  • Pharmacology
  • Microbiology (medical)

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