The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

Multi-Drug Resistant Streptoccocus Pneumoniae in a Subacute Facility

Donald Janner,MD , D Regitor; Kathy Comer, MSN, FNP; Helen Newsom, BSN, NP; Daved vanStralen Md; Ravindra Rao, MD; Doug Padgett, BS, NHA. Totally Kids® SpecialtyHealthcare, Loma Linda, CA; Loma Linda University Medical Center, Loma Linda,CA.

Purpose: Multiple drug resistancehas become a problem in long-term care facilities. We describe multiple drugresistance in Streptoccocus pneumoniae from tracheal aspirates at a long-termfacility.

Methods: Patients are froma 50-bed, freestanding, pediatric subacute facility for tracheostomy dependentpatients (ventilator and non-ventilator dependent). Tracheal cultures obtainedfor body temperature greater than 38.3°C, change in respiratory status orchange in secretions (thick, green). Minimal inhibitory concentrations (MIC)were determined by e-test for penicillin and deflriaxone.

Results: 221 cultures, 25(11%) were positive for Streptoccocus from 17 patients.

Antiobiotic Resistance(MIC in mcg)Specimensn (%)
Penicillin>219 (76%)
Penicillin>44 (16%)
Ceftriaxone>1.015 (60%)
Ceftriaxone>2.05 (20%)

Data shown are mean ±SD. Numbers in parenthesis indicate range.

Conclusion: The HHs reportedhere failed to maintain the airway opeing T at the set point or T varied greatlyunder pediatric ventilatory settings with a low continuous flow.

ClinicalImplications: Multiple antibiotic resistance of Streptoccocus pneumoniaecan occur in long-term care facilities. MIC may help guide therapy.


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