Evidence map›Paper›PMID 15273115›Full record

ArticleAntimicrobial agents and chemotherapy2004

Emergence of Streptococcus pneumoniae with very-high-level resistance to penicillin.

Stephanie J Schrag, Lesley McGee, Cynthia G Whitney, Bernard Beall, Allen S Craig, Miriam E Choate, James H Jorgensen, Richard R Facklam, Keith P Klugman, Active Bacterial Core Surveillance Team

Open access · greenAbstract read
In one paragraph

Article in Antimicrobial agents and chemotherapy, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed
7.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 99 citations in OpenAlex.

  1. Trial
  2. Montelukast treatsMicrobiology spectrum · 2025
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  6. Review
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  8. CRH Affects the Phenotypic Expression of Sepsis-Associated Virulence Factors byFrontiers in cellular and infection microbiology · 2017
    Article
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  19. Pneumonia and other respiratory infections.Pediatric clinics of North America · 2009
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Stephanie J SchragDivision of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Lesley McGee
Cynthia G Whitney
Bernard Beall
Allen S Craig
Miriam E Choate
James H Jorgensen
Richard R Facklam
Keith P Klugman
Active Bacterial Core Surveillance Team
National Center for Infectious Diseases · USEmory University · USTennessee Department of Health · USThe University of Texas Health Science Center at San Antonio · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Penicillin resistance threatens the treatment of pneumococcal infections. We used sentinel hospital surveillance (1978 to 2001) and population-based surveillance (1995 to 2001) in seven states in the Active Bacterial Core surveillance of the Emerging Infections Program Network to document the emergence in the United States of invasive pneumococcal isolates with very-high-level penicillin resistance (MIC > or = 8 microg/ml). Very-high-level penicillin resistance was first detected in 1995 in multiple pneumococcal serotypes in three regions of the United States. The prevalence increased from 0.56% (14 of 2,507) of isolates in 1995 to 0.87% in 2001 (P = 0.03), with peaks in 1996 and 2000 associated with epidemics in Georgia and Maryland. For a majority of the strains the MICs of amoxicillin (91%), cefuroxime (100%), and cefotaxime (68%), were > or =8 microg/ml and all were resistant to at least one other drug class. Pneumonia (50%) and bacteremia (36%) were the most common clinical presentations. Factors associated with very highly resistant infections included residence in Tennessee, age of <5 or > or =65 years, and resistance to at least three drug classes. Hospitalization and case fatality rates were not higher than those of other pneumococcal infection patients; length of hospital stay was longer, controlling for age. Among the strains from 2000 and 2001, 39% were related to Tennessee(23F)-4 and 35% were related to England(14-)9. After the introduction of the pneumococcal conjugate vaccine, the incidence of highly penicillin resistant infections decreased by 50% among children <5 years of age. The emergence, clonality, and association of very-high-level penicillin resistance with multiple drug resistance requires further monitoring and highlights the need for novel agents active against the pneumococcus.

Indexed as

DNA-Cytosine MethylasesElectrophoresis, Gel, Pulsed-FieldHumansMicrobial Sensitivity TestsMolecular EpidemiologyPenicillin ResistancePenicillinsPneumococcal InfectionsPneumococcal VaccinesPopulationPopulation SurveillanceRisk FactorsStreptococcus pneumoniaeUnited StatesDNA-Cytosine MethylasesDNA modification methylase XcyIPenicillinsPneumococcal Vaccines

Identifiers

PMID15273115
PMCPMC478489
OpenAlexW2137532164

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.