Drug-Resistant Pneumococcal Infections in the United States

Drug-resistantStreptococcus pneumoniae(DRSP) strains were once considered to be laboratory curiosities¹,²or problems for far-off areas of the world.³⁻⁵In the United States, however, pneumococci that were relatively resistant to penicillin (minimum inhibitory concentration, 0.12 to 1.0 μg/mL) were found among the isolates from Navajo Indians living in New Mexico in 1974,⁶and a serotype 14S pneumoniaeisolate with high-level resistance to penicillin (minimum inhibitory concentration, ≥2.0 μg/mL) was recovered from the blood of an immunocompromised child from Minnesota in 1977.⁷Since these initial reports, foci of DRSP have been identified in various parts of this country.⁸⁻¹²The reports from the Centers for Disease Control and Prevention from Kentucky and Tennessee,¹³from Connecticut,¹⁴and by Breiman et al¹⁵in this issue ofThe JOURNALare alarming because they prove that DRSP isolates can now be found in unselected, diverse sites