Rapidly increasing prevalence of penicillin-resistant Streptococcus pneumoniae in middle Tennessee: a 10-year clinical and molecular analysis.

Tang YW, Li H, Griffin JP, Haas DW, D'Agata EM
J Clin Microbiol. 2002 40 (2): 395-9

PMID: 11825948 · PMCID: PMC153403 · DOI:10.1128/jcm.40.2.395-399.2002

The clinical and molecular epidemiology of penicillin-resistant Streptococcus pneumoniae and the diagnostic accuracy of a six-primer PCR assay in identifying penicillin resistance were analyzed by using clinical isolates recovered over a 10-year period in middle Tennessee. The prevalence of non-penicillin-susceptible S. pneumoniae isolates (MIC, > or =0.1 microg/ml) increased from 10% in 1990 to 70% in 1999 (P < 0.001). Among S. pneumoniae isolates for which the penicillin MIC was > or =2 microg/ml (highly penicillin-resistant S. pneumoniae [PRSP]), 23 and 5% were resistant to at least three and at least five other antimicrobial classes, respectively. Pulsed-field gel electrophoresis identified 13 unique strain types, with type B accounting for 33% of PRSP isolates. The sensitivity, specificity, and negative and positive predictive values of the PCR assay in detecting PRSP were 99, 100, 99, and 100%, respectively. Penicillin resistance is rapidly increasing among S. pneumoniae isolates in Tennessee. The simultaneous detection of S. pneumoniae and high-level penicillin resistance can be accurately performed with the six-primer PCR assay.

MeSH Terms (18)

Adolescent Adult Aged Anti-Bacterial Agents Child Child, Preschool Electrophoresis, Gel, Pulsed-Field Female Humans Male Microbial Sensitivity Tests Middle Aged Penicillin Resistance Pneumococcal Infections Prevalence Serotyping Streptococcus pneumoniae Tennessee

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