Penicillin Resistant Streptococcus pneumonia

Abstract

Penicillin Resistant Streptococcus pneumonia

Warangkana       Munsakul                       MD

Petch                    Rawdaree                      MD,MSc Epidemiology, DLSHTM

Department of Medicine, BMA Medical College and Vajira Hospital

Objective : To determine the prevalence of penicillin - resistant Streptococcus pneumonia (PRSP) and to compare clinical difference of infection by penicillin - resistant Streptococcus pneumonia and penicillin - sensitive Streptococcus pneumoniae (PSSP).

Study design : Cross - sectional descriptive study.

Subjects : Sixty three Streptococcus pneumonia infected patients were studied from January 1996 to December 2000 in BMA Medical College and Vajira Hospital.

Methods : Age, sex, symptoms, signs, prior antibiotic use, underlying diseases, smoking, length of hospital stay, culture, sensitivity and outcome of treatment were recorded from medical records. The data were analyzed to determine prevalence of PRSP and clinical difference between PRSP and PSSP infection.

Main outcome measures : Prevalence of PRSP, clinical difference between PRSP and PSSP infection.

Results : The prevalence of PRSP since 1996-2000 were 14.3%, 0%, 29.6%, 20.0% and 27.3% respectively. The clinical data of PRSP and PSSP (mean age, underlying diseases, smoking, duration of fever prior to admission, white blood count, length of hospital stay, bacteremia, mortality rate) were no statistically significant difference. The sensitivity to chloramphenical, erythromycin, co-trimoxazole and tetracycline of Streptococcus pneumoniae were 73.3%, 60.7%, 47.5% and 45,9% respectively, but the results of PRSP were 50.0%, 21.4%, 21.4% and 18.2% respectively. The sensitivity to cefotaxime and vancomycin if PRSP were both 100%. Drug - resistant Streptococcus pneumonia (DRSP) was 86.7% of PRSP.

Conclusion : The prevalence of PRSP sine 1996-2000 were 14.3%, 0%, 29.6%, 20.0% and 27.3% respectively. There was no statistically significant difference between the clinical data of the PRSP and PSSP  groups Most of PRSP were DRSP.

Key words : penicillin-resistant Streptococcus pneumoniae (PRSP), drug-resistant Streptococcus pneumonia (DRSP), prevalence

Vajira Med J 2002 ; 46 : 19 - 26