[Resistance to penicillin G and Streptococcus pneumoniae infection at the Hôpital Foch, Paris, France, in 1995].

UNLABELLED: Decreased susceptibility to penicillin G of pneumococcal strains is continuously increasing in France.

OBJECTIVE

We assessed effect of resistance to penicillin on therapeutic management and mortality in adults with pneumococcal pneumonia in our hospital.

METHODS

This one-year retrospective study (1995) included patients with proven pneumococcal infection (positive blood culture, pleural fluid, or specimens from the lower respiratory tract). Strains of Streptococcus pneumoniae were screened for susceptibility to antimicrobial agents. Resistance to penicillin G was defined as a minimal inhibitory concentration > or = 0.12 microgram/ml. Age immune and nosocomial status, first and second line antibiotherapy and death were compared according to the strains susceptibility to penicillin G. A p value below 0.05 was statistically significant.

RESULTS

In 15 cases a pneumococcal strain susceptible to penicillin G was isolated while 23 patients were infected with a strain with a decreased susceptibility to penicillin G. Age was significantly higher in the latest group (61.6 versus 54.7 years) while no difference was noted between the 2 groups according to immune and nosocomial status, therapeutic management and death.

DISCUSSION: Resistance to penicillin did neither appear to increase mortality nor to influence therapeutic management in patients with pneumococcal infection.