An international prospective study of pneumococcal bacteremia: correlation with in vitro resistance, antibiotics administered, and clinical outcome - PubMed (original) (raw)
. 2003 Jul 15;37(2):230-7.
doi: 10.1086/377534. Epub 2003 Jul 7.
Christine C C Chiou, Charles Feldman, Ake Ortqvist, Jordi Rello, Arthur J Morris, Larry M Baddour, Carlos M Luna, David R Snydman, Margaret Ip, Wen Chien Ko, M Bernadete F Chedid, Antoine Andremont, Keith P Klugman; International Pneumococcal Study Group
Affiliations
- PMID: 12856216
- DOI: 10.1086/377534
An international prospective study of pneumococcal bacteremia: correlation with in vitro resistance, antibiotics administered, and clinical outcome
Victor L Yu et al. Clin Infect Dis. 2003.
Abstract
We performed a prospective, international, observational study of 844 hospitalized patients with blood cultures positive for Streptococcus pneumoniae. Fifteen percent of isolates had in vitro intermediate susceptibility to penicillin (minimum inhibitory concentration [MIC], 0.12-1 microg/mL), and 9.6% of isolates were resistant (MIC, >or=2 microg/mL). Age, severity of illness, and underlying disease with immunosuppression were significantly associated with mortality; penicillin resistance was not a risk factor for mortality. The impact of concordant antibiotic therapy (i.e., receipt of a single antibiotic with in vitro activity against S. pneumoniae) versus discordant therapy (inactive in vitro) on mortality was assessed at 14 days. Discordant therapy with penicillins, cefotaxime, and ceftriaxone (but not cefuroxime) did not result in a higher mortality rate. Similarly, time required for defervescence and frequency of suppurative complications were not associated with concordance of beta-lactam antibiotic therapy. beta-Lactam antibiotics should still be useful for treatment of pneumococcal infections that do not involve cerebrospinal fluid, regardless of in vitro susceptibility, as determined by current NCCLS breakpoints.
Comment in
- Clinical outcome of pneumococcal bacteremia, in vitro resistance, and antibiotic therapy.
Torres-Tortosa M, Caballero-Granado J, Canueto J, Moreno-Maqueda I. Torres-Tortosa M, et al. Clin Infect Dis. 2004 Mar 1;38(5):763-4; author reply 765-6. doi: 10.1086/381759. Clin Infect Dis. 2004. PMID: 14986265 No abstract available. - Antimicrobial selection for penicillin-resistant pneumococcal bacteremia.
Hill AR. Hill AR. Clin Infect Dis. 2004 Mar 1;38(5):763; author reply 765-6. doi: 10.1086/381757. Clin Infect Dis. 2004. PMID: 14986266 No abstract available. - Clinical significance of Streptococcus pneumoniae resistance reporting remains confusing.
Siegel RE. Siegel RE. Clin Infect Dis. 2004 Mar 1;38(5):764-5; author reply 765-6. doi: 10.1086/381756. Clin Infect Dis. 2004. PMID: 14986267 No abstract available.
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