Penicillin-resistant Streptococcus Pneumoniae

Streptococcus pneumoniae is a major cause of pneumonia, meningitis, septicemia, acute otitis media, and other serious infections, severely affecting infants, young children, and the elderly. In the past, S. pneumoniae was uniformly susceptible to penicillin, which remained the drug of choice for serious infections. However, since the mid-1960s, resistance to penicillin, which was first reported in Australia, has been occurring with greater frequency in various parts of the world. The percentage of penicillin-resistant S. pneumoniae (PRSP) isolates with resistance to other primary therapeutic agents such as trimethoprim/ sulfamethoxazole (TMP/SMX), erythromycin, tetracycline, and chloramphenicol as well as agents which are used for multi-drug resistant isolates, such as ceftriaxone and cefotaxime, is also increasing in various parts of the world. In Canada, an isolate with reduced susceptibility to penicillin was first reported in 1974, and a multi-resistant strain of S. pneumoniae was first reported in 1983. A survey of the literature indicates that the prevalence of PRSP varies across Canada, and a recent report from Quebec shows that levels of resistance are increasing.