TYPE VIII PNEUMOCOCCUS: DEVELOPMENT OF SULFADIAZINE RESISTANCE, TRANSMISSION BY CROSS INFECTION, AND PERSISTENCE IN CARRIERS

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Abstract
A case of pneumonia due to a Type VIII pneumococcus was originally sensitive to sulfadiazine but became resistant during treatment. This same strain was then transmitted by contact to a 2d patient in an adjacent bed and later produced a pneumonia which also failed to respond to treatment with sulfadiazine. Drug-fastness was evidenced by the development of a positive blood culture during therapy in one patient, an extension of the pneumonia to other lobes in both patients, a marked increase in the number of pneumococci in the sputum in both patients, and the growth of these organisms in media containing 10-20 mg.% of sulfadiazine. Growth of these same cultures was inhibited by 5-10 mg.% of sulfathiazole. After sulfadiazine-resistance had become apparent, serum and sulfathiazole were adm. to both patients and recovery followed. Evidence was obtained from the sputum that each of the latter agents exerted its characteristic therapeutic effect. In addition, a follow-up study revealed that both patients continued to carry virulent sulfa-diazine-resistant strains of Type VIII pneumococci in their sputum for at least 2 mos. after hospitalization.

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