PMID- 10728733
OWN - NLM
STAT- MEDLINE
DCOM- 20000411
LR  - 20191103
IS  - 1323-7799 (Print)
IS  - 1323-7799 (Linking)
VI  - 5
IP  - 1
DP  - 2000 Mar
TI  - A comparative clinical study of pneumonia by penicillin-resistant and -sensitive 
      Streptococcus pneumoniae in a community hospital.
PG  - 59-64
AB  - OBJECTIVE: This study aimed to determine the clinical difference of pneumonia 
      between penicillin-resistant and penicillin-sensitive Streptococcus pneumoniae. 
      METHODOLOGY: Forty-nine cases in 46 patients of pneumococcal pneumonia were 
      studied from December 1992 to May 1997. There were 24 cases (in 22 patients) of 
      penicillin-resistant pneumococci (PRSP) pneumonia which were compared with 25 
      cases (in 24 patients) with penicillin-sensitive pneumococci (PSSP). RESULTS: 
      Both the mean age and the underlying disease states did not differ between the 
      two groups. However, hospital-acquired pneumonia and previous use of antibiotics 
      were observed in eight (33.3%) and 12 (50.0%) patients in PRSP compared with 
      three (12.0%) and two (8.0%) in PSSP, respectively. The clinical efficacy rate 
      and bacteriological eradication rates were 87.5 and 87.5% in PRSP compared with 
      87.5 and 87.0% in PSSP, respectively. Minimum inhibitory concentration (MIC) of 
      antibiotics against 30 pneumococcal isolates was examined, and 10 strains ranged 
      from 0.10-0.78 microg/mL and five strains were more than 1.56 microg/mL against 
      penicillin G, while the MIC showed higher resistance to other antibiotics except 
      for the carbapenems. Serotyping of the isolates by antiserum revealed differences 
      in the predominant types PRSP (19F) and PSSP (6A,9V) [corrected]. CONCLUSIONS: We 
      must care for not only community-acquired infection but also nosocomial 
      transmission of PRSP pneumonia. Most patients with infections due to PRSP tended 
      to have a milder illness with a good outcome (no patient died). As such it 
      appears that empiric therapy for pneumococcal pneumonia does not require 
      modification from what is recommended at present. However, in patients with 
      infection due to highly resistant strains, and who are not responding to 
      conventional therapy should have their treatment modified according to subsequent 
      susceptibility testing.
FAU - Watanabe, H
AU  - Watanabe H
AD  - Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki 
      University, Japan. h-wata@net.nagasaki-u.ac.jp
FAU - Sato, S
AU  - Sato S
FAU - Kawakami, K
AU  - Kawakami K
FAU - Watanabe, K
AU  - Watanabe K
FAU - Oishi, K
AU  - Oishi K
FAU - Rikitomi, N
AU  - Rikitomi N
FAU - Ii, T
AU  - Ii T
FAU - Ikeda, H
AU  - Ikeda H
FAU - Sato, A
AU  - Sato A
FAU - Nagatake, T
AU  - Nagatake T
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Australia
TA  - Respirology
JT  - Respirology (Carlton, Vic.)
JID - 9616368
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
EIN - Respirology 2001 Mar;6(1):85
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Female
MH  - Humans
MH  - Male
MH  - Microbial Sensitivity Tests
MH  - Middle Aged
MH  - *Penicillin Resistance
MH  - Pneumonia, Pneumococcal/diagnosis/drug therapy/*microbiology
MH  - Serotyping
MH  - Streptococcus pneumoniae/classification/*drug effects
EDAT- 2000/03/23 09:00
MHDA- 2000/04/15 09:00
CRDT- 2000/03/23 09:00
PHST- 2000/03/23 09:00 [pubmed]
PHST- 2000/04/15 09:00 [medline]
PHST- 2000/03/23 09:00 [entrez]
AID - 10.1046/j.1440-1843.2000.00227.x [doi]
PST - ppublish
SO  - Respirology. 2000 Mar;5(1):59-64. doi: 10.1046/j.1440-1843.2000.00227.x.