We monitored the susceptibility to penicillin of invasive strains of Streptococcus pneumoniae in two reference laboratories; 502 positive cultures from patients with an active invasive infectious process were analyzed. Streptococcus pneumoniae was identified through conventional procedures, and the oxacillin disc diffusion method was used to check for penicillin susceptibility. Statistical analysis included calculations of the frequency distribution, with 95% confidence intervals (CI), as well as chi-square tests and chi-square for linear trend for temporal analysis of susceptibility. The bacterium was isolated from patients less than a year old (40.7% of the isolates), from infants (55.9%), and from individuals less than 15 years old (64.4%). The majority (88.2%, 95% CI = 85.5%-91.1%) of the 502 isolates were susceptible to penicillin. There was no significant temporal trend of elevation of resistance rate during the study period (p=0.56). We conclude that resistance of S. pneumoniae to penicillin is not yet an important clinical-epidemiological concern in the State of Minas Gerais. To provide necessary support for the adoption of therapeutic and prophylactic measures, epidemiological surveillance should be implemented at a national level to monitor the profile of susceptibility/resistance of S. pneumoniae to penicillin and other antimicrobials.
The accuracy of the latex particle agglutination test (LPAT) was assessed in blood stained cerebrospinal fluid (CSF) specimens from 166 paediatric patients, aged from three months to 13 years. A commercial LPAT kit was used to detect Haemophilus influenzae type b, Streptococcus pneumoniae, and Neisseria meningitidis A, B, and C soluble antigens. Culture of CSF specimens was used as the standard and all laboratory procedures were performed blind. The mean CSF erythrocyte count was 66 406 cells/num3 in the cases and 11560 cellslmm3 in the controls. The sensitivity and the specificity of LPAT were 83*8 and 94 0%, respectively, suggesting that LPAT is a useful diagnostic tool even in blood stained CSF specimens.
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