Surveillance for penicillin-nonsusceptible Streptococcus pneumoniae–New York City, 1995

Streptococcus pneumoniae has become a leading cause of bacteremia, pneumonia, meningitis, and otitis media in the United States. Persons at increased risk include young children, immunocompromised persons, and the elderly. Until 1987, S. pneumoniae was uniformly susceptible to penicillin; since then, in the United States, there has been increased identification of penicillin-nonsusceptible S. pneumoniae (PNSP) (defined as minimum inhibitory concentration [MIC] to penicillin > or = 0.1 microgram/mL), especially penicillin-resistant S. pneumoniae (PRSP) (defined as MIC to penicillin > or = 2.0 micrograms/mL). In addition, PNSP is becoming less susceptible to other antimicrobial drugs, including tetracycline, erythromycin, extended-spectrum cephalosporins, and chloramphenicol; some are susceptible only to vancomycin. Because of the emergence of PNSP, in December 1994, the New York City Department of Health (NYCDOH) amended the New York City health code to require reporting of PNSP to monitor the local prevalence of resistance to penicillin. This report summarizes surveillance findings from NYCDOH’s data for 1995, which indicate that the highest case rates were among children aged < 4 years and that, among adults aged 20-44 years with PNSP infections, 71.4% also were infected with human immunodeficiency virus (HIV).