American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following is NOT considered a risk factor for drug-resistant Streptococcus pneumoniae?

1. Diabetes mellitus

2. Recent antibiotic use

3. Young age

4. Chronic kidney disease

The correct answer is: Young age

Young age is not considered a risk factor for drug-resistant Streptococcus pneumoniae primarily because children, particularly those under five years old, are more likely to be affected by pneumonia caused by Streptococcus pneumoniae in general, but they do not typically carry a higher risk for developing drug-resistant strains. In contrast, conditions like diabetes mellitus and chronic kidney disease are associated with a compromised immune response, making individuals more susceptible to infections and potentially contributing to the emergence of antibiotic resistance. Recent antibiotic use is also a well-established risk factor, as it can disrupt normal flora and foster an environment where resistant strains can thrive. Hence, young age generally does not align with the risk factors that lead to drug-resistant infections in the same way that those chronic conditions do.