Prevalence and Clinical Outcome of Penicillin-resistant Pneumococcal Pneumonia.
10.4046/trd.2003.54.3.295
- Author:
Ji Hyun HONG
1
;
Hyung Seok LEE
;
Seung Hyun JUNG
;
Gyu Won KIM
;
Kwang Seok EOM
;
Jae Myung LEE
;
Seung Hun JANG
;
Dong Gyu KIM
;
In Gyou HYOEN
;
Myoung Koo LEE
;
Yong Bum PARK
;
Ki Suck JUNG
;
Young Kyoung LEE
Author Information
1. Division of Pulmonology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea. pulmoks@hallym.or.kr
- Publication Type:Original Article
- Keywords:
Penicillin-resistance;
Streptococcus pneumoniae;
Pneumonia;
Prognosis
- MeSH:
Classification;
Humans;
Incidence;
Korea;
Penicillin Resistance;
Penicillins;
Pneumonia;
Pneumonia, Pneumococcal*;
Prevalence*;
Prognosis;
Streptococcus;
Streptococcus pneumoniae
- From:Tuberculosis and Respiratory Diseases
2003;54(3):295-303
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The incidence of penicillin-resistant streptococcus pneumoniae(PRSP) accounts for almost 70% of all pneumococcal pneumonia cases in Korea. It is still unclear as to whether the efficacy of penicillin or equally active beta-lactam agents is compromised in PRSP pneumonia. This study investigated the prevalence of PRSP in community-acquired pneumonia and its clinical course. METHODS: A total of 42 patients with community-acquired pneumococcal pneumonia were evaluated from July 1999 to May 2001. The cultured strains of Streptococcus pneumoniae were divided into susceptible, intermediately resistant, and resistant strains by an E-test, and the effect of the clinical course was investigated. RESULTS: From a total of 42 patients, 22 (52.4%) patients had an intermediate resistance (MIC 0.1-1 microgram/ml) and six (14.3%) showed a high resistance (MIC> or =2.0 microgram/ml) with current penicillin susceptibility categories. However, according to the classification of the DRSPTWG (Drug Resistant Streptococcus pneumoniae Therapeutic Working Group), there were 11 cases (26.2%) of intermediate resistance and no case of high resistance. Under empirical antimicrobial treatment, there was no difference in the clinical outcome between the penicillin susceptible and resistant group. CONCLUSION: The clinical outcome of PRSP pneumonia with empirical therapy was acceptable. These results suggest that the current MIC breakpoint for penicillin resistance in Streptococcus pneumoniae has been set at a very low level and penicillin resistance according to the NCCLS classification does not significantly influence the outcome of the empirical treatment for pneumococcal pneumonia.
