Journal Article

High-Level Penicillin-Nonsusceptible <i>Streptococcus pneumoniae</i> Bacteremia: Identification of a Low-Risk Subgroup

Jörg J. Ruhe, Leann Myers, David Mushatt and Rodrigo Hasbun

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 4, pages 508-514
Published in print February 2004 | ISSN: 1058-4838
Published online February 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/381197
High-Level Penicillin-Nonsusceptible Streptococcus pneumoniae Bacteremia: Identification of a Low-Risk Subgroup

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High-level penicillin resistance has been associated with treatment failure in patients with Streptococcus pneumoniae infections. To identify a subgroup of patients at low risk for high-level penicillin-nonsusceptible S. pneumoniae bacteremia, a cross-sectional study of 303 patients was performed. For the total study population, penicillin resistance was observed in 98 (32%) of 303 patients; high-level resistance was seen in 33 (11%). A predictive model was created by using 3 baseline variables that were independently associated with high-level penicillin resistance: previous β-lactam antibiotic use, previous stay in a risk area (defined as stay in day care facilities, prisons, homeless shelters, nursing homes, or other long-term care facilities), and previous respiratory tract infection. The model was used to identify patients at low and high risk for high-level penicillin-resistant pneumococcal bacteremia. None of the isolates of patients in the low-risk subgroup had ceftriaxone resistance. Patients in the low-risk subgroup could be empirically treated with fluoroquinolone-sparing regimens.

Journal Article.  4098 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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