American Board of Internal Medicine (ABIM) Certification Practice Exam

Which condition is NOT a risk factor for developing drug-resistant S. pneumoniae?

1. Asplenia

2. Chronic liver disease

3. Obesity

4. Malignancies

The correct answer is: Obesity

Obesity is not recognized as a direct risk factor for developing drug-resistant Streptococcus pneumoniae. The other conditions—such as asplenia, chronic liver disease, and malignancies—are associated with various immunocompromised states and increased susceptibility to infections, including drug-resistant strains. Asplenia, for instance, significantly compromises the body's ability to clear encapsulated organisms like S. pneumoniae, making individuals more vulnerable to severe infections and potentially leading to increased likelihood of encountering antibiotic-resistant strains. Chronic liver disease can impair the immune response and influence clearance of pathogens, while malignancies, especially those impacting the immune system or treated with immunosuppressive therapies, also heighten the risk for infections by both susceptible and resistant bacteria. In contrast, while obesity may contribute to other health issues and some infections, it doesn't specifically correlate with the development of drug-resistant S. pneumoniae in the same way as the other mentioned risk factors. Thus, obesity is less directly linked to antimicrobial resistance mechanisms in this specific context.