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Risk factors and clinical outcomes of penicillin resistant S. pneumoniae community-acquired pneumonia in Khon Kaen, Thailand.
Southeast Asian J Trop Med Public Health. 2006 Mar; 37(2):320-6.SA

Abstract

To determine the prevalence, risk factors and clinical outcomes of penicillin-resistant S. pneumoniae (PRSP) in community-acquired pneumonia (CAP), a cross-sectional study was conducted between January 1995 and December 2004 at Srinagarind Hospital, Khon Kaen, Thailand. Patients hospitalized with CAP and culture proved to be S. pneumoniae were included. PRSP was found in 22 of 64 (34.4%) patients. The MIC levels of penicillin non-susceptible strains ranged between 0.25 and 0.75 microg/ml. Resistance to other antibiotics ranked: cotrimoxazole (51.6%), tetracycline (26.6%), erythromycin (20.6%), lincomycin (18.7%), chloramphenicol (12.5%) and ampicillin (1.6%). None of the isolates was resistant to cephalothin. The significant risk factors for PRSP infection were previous antibiotic use within 3 months (Adjusted OR 40.83, 95% CI 3.71 to 449.41) and alcoholism (Adjusted OR 8.82, 95% 1.25 to 62.46). Bacteremia and empyema thoracis were found more commonly in PRSP than PSSP infection, but not statistically significant. Pneumonia-related mortality was nearly the same, PRSP 9.1% vs PSSP 9.5% (p = 0.96). The reason why the clinical outcomes of these two groups were not different may be the patients were infected with mildly resistant organisms. Thus, pneumonia caused by intermediate-level penicillin resistant S. pneumoniae appears to be adequately treated with beta-lactams or aminopenicillin antibiotics. The MIC levels of penicillin resistance should be monitored further. The need for antibiotics active against drug-resistant S. pneumoniae was required if high-level penicillin resistance was detected.

Authors+Show Affiliations

Reechaipichitkul W
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. Wipree@yahoo.com
Assawasanti K
No affiliation info available
Chaimanee P
No affiliation info available

MeSH

AdolescentAdultAgedAged, 80 and overAnti-Bacterial AgentsCommunity-Acquired InfectionsCross-Sectional StudiesDrug Resistance, Multiple, BacterialFemaleHumansMaleMicrobial Sensitivity TestsMiddle AgedPenicillin ResistancePneumonia, PneumococcalRisk FactorsStreptococcus pneumoniaeThailandTreatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17124993

Citation

Reechaipichitkul, Wipa, et al. "Risk Factors and Clinical Outcomes of Penicillin Resistant S. Pneumoniae Community-acquired Pneumonia in Khon Kaen, Thailand." The Southeast Asian Journal of Tropical Medicine and Public Health, vol. 37, no. 2, 2006, pp. 320-6.
Reechaipichitkul W, Assawasanti K, Chaimanee P. Risk factors and clinical outcomes of penicillin resistant S. pneumoniae community-acquired pneumonia in Khon Kaen, Thailand. Southeast Asian J Trop Med Public Health. 2006;37(2):320-6.
Reechaipichitkul, W., Assawasanti, K., & Chaimanee, P. (2006). Risk factors and clinical outcomes of penicillin resistant S. pneumoniae community-acquired pneumonia in Khon Kaen, Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health, 37(2), 320-6.
Reechaipichitkul W, Assawasanti K, Chaimanee P. Risk Factors and Clinical Outcomes of Penicillin Resistant S. Pneumoniae Community-acquired Pneumonia in Khon Kaen, Thailand. Southeast Asian J Trop Med Public Health. 2006;37(2):320-6. PubMed PMID: 17124993.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors and clinical outcomes of penicillin resistant S. pneumoniae community-acquired pneumonia in Khon Kaen, Thailand. AU - Reechaipichitkul,Wipa, AU - Assawasanti,Kanogsri, AU - Chaimanee,Prajuap, PY - 2006/11/28/pubmed PY - 2007/1/24/medline PY - 2006/11/28/entrez SP - 320 EP - 6 JF - The Southeast Asian journal of tropical medicine and public health JO - Southeast Asian J Trop Med Public Health VL - 37 IS - 2 N2 - To determine the prevalence, risk factors and clinical outcomes of penicillin-resistant S. pneumoniae (PRSP) in community-acquired pneumonia (CAP), a cross-sectional study was conducted between January 1995 and December 2004 at Srinagarind Hospital, Khon Kaen, Thailand. Patients hospitalized with CAP and culture proved to be S. pneumoniae were included. PRSP was found in 22 of 64 (34.4%) patients. The MIC levels of penicillin non-susceptible strains ranged between 0.25 and 0.75 microg/ml. Resistance to other antibiotics ranked: cotrimoxazole (51.6%), tetracycline (26.6%), erythromycin (20.6%), lincomycin (18.7%), chloramphenicol (12.5%) and ampicillin (1.6%). None of the isolates was resistant to cephalothin. The significant risk factors for PRSP infection were previous antibiotic use within 3 months (Adjusted OR 40.83, 95% CI 3.71 to 449.41) and alcoholism (Adjusted OR 8.82, 95% 1.25 to 62.46). Bacteremia and empyema thoracis were found more commonly in PRSP than PSSP infection, but not statistically significant. Pneumonia-related mortality was nearly the same, PRSP 9.1% vs PSSP 9.5% (p = 0.96). The reason why the clinical outcomes of these two groups were not different may be the patients were infected with mildly resistant organisms. Thus, pneumonia caused by intermediate-level penicillin resistant S. pneumoniae appears to be adequately treated with beta-lactams or aminopenicillin antibiotics. The MIC levels of penicillin resistance should be monitored further. The need for antibiotics active against drug-resistant S. pneumoniae was required if high-level penicillin resistance was detected. SN - 0125-1562 UR - https://www.unboundmedicine.com/medline/citation/17124993/Risk_factors_and_clinical_outcomes_of_penicillin_resistant_S__pneumoniae_community_acquired_pneumonia_in_Khon_Kaen_Thailand_ L2 - https://medlineplus.gov/antibiotics.html DB - PRIME DP - Unbound Medicine ER -