All issues > Volume 48(1); 2005

Original Article

Korean J Pediatr. 2005;48(1):40-47. Published online January 15, 2005.

Penicillin Resistant Distribution and in-vitro Susceptibility of Oral Antibiotics against Streptococcus pneumoniae, isolated from Pediatric Patients with Community- Acquired Respiratory Infections in Korea

Jin Han JH Kang¹, Sun Mi SM Kim¹, Jong Hyun JH Kim¹, Hur Jae HJ Kyun¹, Kyung Yil KY Lee¹, Young Ku YK Shin², Su Eun SE Park³, Sang Hyuk SH Ma⁴, Young Jin YJ Hong⁵

¹Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul,
²Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
³Department of Pediatrics, College of Medicine, Busan National University, Busan
⁴Department of Pediatrics, College of Medicine, Masan Fatima Hospital , Masan, Korea
⁵Department of Pediatrics, College of Medicine, Inha University

Correspondence Jin Han JH Kang ,Email: kjhan@olmh,cuk.ac.kr

Abstract

Purpose
: S. pneumoniae is one of major pathogens of community-acquired respiratory infections. The rate of antibiotic resistance to this organism has increased, and resistance to multiple antimicrobial agents in a single strain of S. pneumoniae may compromise the efficacy of empiric antimicrobial treatment commonly used for respiratory infections. We did this study to find out the penicillin resistant distributions and oral antibiotics susceptibility patterns against S. pneumoniae, isolated from pediatric patients with community-acquired respiratory infections in Korea.
Methods
: One hundred fifty six pneumococcal isolates obtained from pediatric patients with community-acquired respiratory infections such as acute otitis media(AOM), sinusitis and pneumonia between May 2000 to June 2003. And MICs of penicillin and oral antibiotics(amoxicillin, amoxicillin- clavulanate, cefaclor) were performed by broth microdilution methods according to the NCCLS(2003a).
Results
: Seventy eight percent of the isolates were resistant to penicillin. The isolates, collected from AOM patients showed the highest penicillin resistance(92.7%). The resistant rates of amoxicillin (16.7%) and amoxicillin-clavulanate(9.6%), based on susceptibility breakpoints established by the NCCLS, were markedly lower than these of penicillin. But, the resistant rate of cefaclor was very high, above 95%.
Conclusion
: We concluded that pneumococci isolated from study cases may be one of the world's highest penicillin resistant rates. But, amoxicillin and amoxicillin-clavulanate can be used as a first- line antibiotics. Finally, we hope that a continuous surveillance study to monitor resistant patterns of pneumococcal respiratory infections will be needed for the standard guidelines of empiric antibiotic treatment.

Keywords :Respiratory tract infection, Community-acquired infections, Streptococcus pneumoniae, Penicillin resistance, Antibiotic susceptibility