Tuberc Respir Dis > Volume 54(3); 2003 > Article
Tuberculosis and Respiratory Diseases 2003;54(3):295-303.
DOI: https://doi.org/10.4046/trd.2003.54.3.295    Published online March 1, 2003.
Prevalence and Clinical Outcome of Penicillin-resistant Pneumococcal Pneumonia.
Ji Hyun Hong, 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
1Division of Pulmonology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea. pulmoks@hallym.or.kr
2Department of Clinical Pathology, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea.
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.
Key Words: Penicillin-resistance, Streptococcus pneumoniae, Pneumonia, Prognosis


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