S. pneumoniae is a common cause of pneumonia, meningitis, and sinus and ear infections.
"The emergence of drug-resistant S. pneumoniae will make these common infections more difficult to treat," the authors report. "Control of drug-resistant pneumococci will require more judicious use of antimicrobial agents and wider use of the pneumococcal polysaccharide vaccine."
Through an active surveillance program administered by Emory's Division of Infectious Diseases and the Veterans Affairs Medical Center in Decatur, and funded by the CDC, researchers found that one quarter of 431 Atlantans with invasive pneumococcal disease in 1994 were infected by strains of S. pneumoniae resistant to multiple drugs. Many other patients were infected by pathogens resistant to a single drug. For instance, 25 percent of strains were resistant to penicillin and 15 percent to erythromycin.
The researchers report an annual incidence of invasive pneumococcal infection of 30 cases per 100,000 persons in the population.
"We are particularly alarmed by the rapid rise in pneumococcal drug-resistance, moving from a rare to a relatively common occurrence in a few short years," said paper co-author Monica M. Farley, an associate professor of infectious diseases at Emory. "While treatment with currently available drugs remains effective, the choice of antibiotics has become more complex, and trends toward increased levels of resistance may make treatment very difficult in the future."
Farley also said that while blacks were more likely to be diagnosed with pneumococcal infections than whites (58 cases/100,000 among blacks; 18 cases/100,000 among whites), whites were more likely to be infected by a form resistant to drug treatment.
"In Atlanta, children under 6 years of age were more likely than older children and adults to be infected with cefotaxime-resistant or multidrug-resistant isolates; however, we found a disturbingly high incidence of drug-resistant pneumococcal infections among adults," the authors report.
"Our data suggest an urgent need for consensus guidelines for the prevention and treatment of drug-resistant pneumococcal infections."
-- Lorri Preston