Jackson M A, Shelton S, Nelson J D, McCracken G H
Pediatr Infect Dis. 1984 Mar-Apr;3(2):129-32. doi: 10.1097/00006454-198403000-00010.
Two hundred fifty-eight isolates of Streptococcus pneumoniae obtained from 232 infants and children at Children's Medical Center, Dallas, from November 1, 1981, to March 31, 1983, were screened for susceptibility to penicillin. On 1-microgram oxacillin disks 21 strains (8%) had zones of inhibition of 17 mm or less, and the tube-dilution minimal inhibitory concentrations of penicillin were from 0.125 to 0.5 micrograms/ml. These strains were designated as relatively resistant S. pneumoniae (RRSP). Prior therapy with a beta-lactam agent had occurred in 56% of patients with RRSP disease compared with 14% of randomly selected children with infections due to susceptible strains of S. pneumoniae (P = 0.009). Fifteen children (6%) had diseases due to RRSP ranging from sepsis or meningitis to otitis media or conjunctivitis. Four children, including the two patients with meningitis, had unsatisfactory responses to therapy with a beta-lactam antibiotic. Vancomycin or chloramphenicol is preferred for therapy of disease due to RRSP.
1981年11月1日至1983年3月31日期间，从达拉斯儿童医学中心的232名婴幼儿和儿童中分离出258株肺炎链球菌，对其进行青霉素敏感性筛查。在含1微克苯唑西林的纸片上，21株菌株（8%）的抑菌圈直径为17毫米或更小，青霉素的试管稀释最低抑菌浓度为0.125至0.5微克/毫升。这些菌株被指定为相对耐药肺炎链球菌（RRSP）。与14%随机选择的因敏感肺炎链球菌菌株感染的儿童相比，56%的RRSP疾病患者曾接受过β-内酰胺类药物治疗（P = 0.009）。15名儿童（6%）患有RRSP引起的疾病，范围从败血症或脑膜炎到中耳炎或结膜炎。包括两名脑膜炎患者在内的四名儿童，对β-内酰胺类抗生素治疗反应不佳。对于RRSP引起的疾病，首选万古霉素或氯霉素进行治疗。
