Journal article
Nosocomial streptococcal blood stream infections in the SCOPE program: Species occurrence and antimicrobial resistance
Diagnostic Microbiology & Infectious Disease, Vol.29(4), pp.259-263
1997
DOI: 10.1016/S0732-8893(97)00159-4
Abstract
Nosocomial blood stream infections due to streptococci represent an increasingly important problem, particularly among neutropenic cancer patients. This problem is compounded by the emerging resistance to antimicrobial agents commonly used for empiric or prophylactic treatment of hospitalized patients. In this study, we examined the species distribution and antimicrobial susceptibility profile of 295 streptococcal nosocomial blood stream isolates from more than 30 U.S. medical centers (SCOPE National Surveillance Program). Streptococci accounted for 5.9% of all nosocomial blood stream isolates reported. The viridans group streptococci (VGS) were the most frequently isolated streptococci (50.8%), followed by the β-haemolytic streptococci (31.9%) and pneumococci (13.2%). The β-haemolytic streptococci were dominated by serogroup B strains (63%), followed by serogroups A and G. Of these organisms, 193 strains were referred for subsequent monitor susceptibility testing. Approximately 14% of S. pneumoniae, 9.2% of VGS, and 0% of β-haemolytic streptococci were resistant to penicillin. Ceftriaxone was highly active against virtually all isolates (93–100% susceptible) except the VGS (77% susceptible). The rank order for activity of the four agents tested against the 193 isolates was vancomycin > ceftriaxone > penicillin > erythromycin. Importantly, 69% of the penicillin intermediate and resistant strains of VGS were also resistant to at least one additional antimicrobial (31% resistant to ceftriaxone, 51% resistant to erythromycin, 15% resistant to both ceftriaxone and erythromycin). The relatively poor activity of erythromycin against virtually all streptococci and the frequent association of macrolide resistance with penicillin resistance among the VGS suggests that both macrolides and β-lactam agents might have limited values as prophylactic agents for dental procedures and in empiric or prophylactic use in neutropenic patients.
Details
- Title: Subtitle
- Nosocomial streptococcal blood stream infections in the SCOPE program: Species occurrence and antimicrobial resistance
- Creators
- Michael A Pfaller - From the Medical Microbiology Division, University of Iowa College of Medicine, Iowa City, Iowa, USARonald N Jones - From the Medical Microbiology Division, University of Iowa College of Medicine, Iowa City, Iowa, USASteven A Marshall - From the Medical Microbiology Division, University of Iowa College of Medicine, Iowa City, Iowa, USAMichael B Edmond - the Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USARichard P Wenzel - the Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USASCOPE Hosp Stud Grp
- Resource Type
- Journal article
- Publication Details
- Diagnostic Microbiology & Infectious Disease, Vol.29(4), pp.259-263
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0732-8893(97)00159-4
- ISSN
- 0732-8893
- eISSN
- 1879-0070
- Language
- English
- Date published
- 1997
- Academic Unit
- Pathology; Epidemiology; Infectious Diseases; Internal Medicine
- Record Identifier
- 9983905532902771
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