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

Kang, Jin Han; Kim, Sun Mi; Kim, Jong Hyun; Kyun, Hur Jae; Lee, Kyung Yil; Shin, Young Ku; Park, Su Eun; Ma, Sang Hyuk; Hong, Young Jin

Original Article

Korean Journal of Pediatrics 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 Kang¹, Sun Mi Kim¹, Jong Hyun Kim¹, Hur Jae Kyun¹, Kyung Yil Lee¹, Young Ku Shin², Su Eun Park³, Sang Hyuk Ma⁴, Young Jin 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

급성 호흡기감염 환아에서 분리된 폐구균에 대한 페니실린 내성분포와 경구 항생제에 대한 감수성 연구

강진한^¹^, 김선미^¹^, 김종현^¹^, 허재균^¹^, 이경일^¹^, 신영균^²^, 박수은^³^, 마상혁^⁴^, 홍영진^⁵

^¹가톨릭대학교 의과대학 소아과학교실
^²고려대학교 의과대학 소아과학교실
^³부산대학교 의과대학 소아과학교실
^⁴마산 파티마병원 소아과
^⁵인하대학교 의과대학 소아과학교실

Correspondence:
Jin Han 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.

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