Streptococcus pneumoniae Blood Culture Isolates from Patients with and without Human Immunodeficiency Virus Infection: Alterations in Penicillin Susceptibilities and in Serogroups or Serotypes

• Published in: Clinical infectious diseases Vol. 25; no. 5; pp. 1165 - 1172
• Main Authors: Crewe-Brown, Heather H., Karstaedt, Alan S., Saunders, G. Lance, Khoosal, Manikant, Jones, Nicola, Wasas, Avril, Klugman, Keith P.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.11.1997; University of Chicago Press
• Subjects: Adult; Adults; AIDS; AIDS-Related Opportunistic Infections - microbiology; AIDS/HIV; Antibiotics; Biological and medical sciences; Blood; Child; Child health services; Children; Clinical Articles; Female; HIV; Human viral diseases; Humans; Infections; Infectious diseases; Male; Medical sciences; Microbial Sensitivity Tests; Penicillin; Penicillin Resistance; Pneumococcal Infections - complications; Pneumococcal Infections - microbiology; Retrospective Studies; Serotyping; Streptococcus pneumoniae; Streptococcus pneumoniae - classification; Streptococcus pneumoniae - drug effects; Streptococcus pneumoniae - isolation & purification; Tropical medicine; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; South Africa; Africa; Immunopathology; Opportunistic infection; Typing; Drug susceptibility test; AIDS; Immune deficiency; Bacteremia; Streptococcus pneumoniae; Infection; Penicillin derivatives; Streptococcaceae; Antibiotic; Viral disease; Streptococcal infection; Bacteriosis; Bacteria; Micrococcales; Complication; Serotype
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/516104

We performed a 3-year retrospective study of Streptococcus pneumoniae blood culture isolates recovered at Baragwanath Hospital, Soweto, South Africa, from 1993 to 1995. The study group comprised 457 patients, including 98 children, of known human immunodeficiency virus (HIV) serostatus. Of these patients, 70 (30 [8.4%] of 359 adults and 40 [40.8%] of the 98 children) were infected with penicillin-resistant S. pneumoniae strains (minimal inhibitory concentration, ⩾0.12 µg/mL); 56 of these strains were intermediately resistant to penicillin. HIV-positive patients had significantly more penicillin-resistant isolates than did HIV-negative patients (43 [29.7%] of 145 HIV-positive patients vs. 27 [8.6%] of 312 HIV-negative patients; P < .001); this difference was found for both adults (19% vs. 4.3%; P < .001) and children (53.3% vs. 30.2%; P < .0343). Multiple resistance occurred more frequently in HIV-positive children (P = .02). HIV-positive adults had a statistically significant increase in the percentage of serogroups and serotype usually found in children and commonly associated with antimicrobial resistance, i.e., serotype 14 and serogroups 6, 19, and 23 (48% vs. 28.6%; P < .001). The increased prevalence of serogroups or serotypes usually found in children was also found among penicillin-susceptible strains. These data suggest that HIVinfected adults may again become susceptible to the serogroups or serotypes found in children.