Morbidity of penicillin non-susceptible streptococus pneumonia pneumonia

Purpose: It is widely recognized that the incidence of penicillin non-susceptible streptococus pneumoniae (PNSP) is increasing. The presence of PNSP strains is a marker for other antibiotic resistance. The purpose of this study is to evaluate if PNSP infection is associated to increased morbidity in patients with pneumonia. Methods: A prospective review of adults with a documented diagnosis (positive blood cultures) of streptococus pneumoniae pneumonia (n=54). Patients were divided in two groups according to the penicillin sensitivity of the isolate strain, sensitive (MIC₉₀ < 0.25 mcg/ml) and non-sensitive (MIC₉₀ > 0.25 mcg/ml). Results: Sensitive Non-Sensitive P Value Number 47 9 Age* 45 ± 16 49.8 ± 21.1 ns Sex(M/F) 32/15 5/4 ns Saps II Score* 30.8 ± 17.8 28 ± 16.2 ns Hospital Days* 8.2 ± 8.1 14 ± 19.1 ns Deaths 4 (8.51%) 2 (22.2%) ns Pleural Effusion 20 (42.55%) 7 (77.77%) ns Empyema 3 (6.38 %) 2 (22.2 %) ns Antibiotic Days Total* 14.19 ± 6.67 16.44 ± 9.52 ns IV* 6.80 ± 6.6 10.77 ± 11.36 ns *Mean±sd. Conclusions: These results show that patients with pneumonia and positive blood cultures for PNSP although not statistically significant, had a longer hospital stay, with more days of intravenous antibiotic use, and greater incidence of pleural effusion and empyema. Clinical Implications: This study suggests that having a pneumonia due to PNSP can be associated with greater morbidity.