Community-acquired pneumonia: new management strategies for evolving pathogens and antimicrobial susceptibilities

Klugman, Keith P.; Low, Donald E.; Metlay, Joshua P.; Pechère, J.-C.; Weiss, Karl Heinz

doi:10.1016/j.ijantimicag.2004.08.006

Cited by 16 publications

(6 citation statements)

References 99 publications

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“…Continuous monitoring offers the additional advantage of revealing sudden and dangerous changes in resistance trends, an occurrence of remarkable medical significance. In fact, decreased susceptibility to certain classes of drugs, as observed in vitro, may lead to lack of eradication of the causative pathogen thus generating clinical failures and recurrences [11][12][13][14][15][16]. The present Sentinel Project extends previous findings that emerged during longitudinal studies performed in Italy during the 1990s [2,3].…”

Section: Discussionsupporting

confidence: 58%

The Sentinel Project: an update on the prevalence of antimicrobial resistance in community-acquired respiratory Streptococcus pneumoniae and Haemophilus spp. in Italy

Marchese

Ardito

Fadda

et al. 2005

International Journal of Antimicrobial Agents

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Section: Discussionsupporting

confidence: 58%

The Sentinel Project: an update on the prevalence of antimicrobial resistance in community-acquired respiratory Streptococcus pneumoniae and Haemophilus spp. in Italy

Marchese

Ardito

Fadda

et al. 2005

International Journal of Antimicrobial Agents

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“…In this study, we found that 72.6% and 83.3% of all strains were not susceptible to penicillin and macrolides, respectively, numbers that were very close to the findings of previous studies (14,30). One possible cause of the increase in drug resistance is long-term antimicrobial therapy (15). To date it has been thought that the priority for clinicians is to choose the appropriate chemotherapy for patients, usually with underlying diseases.…”

Section: Discussionsupporting

confidence: 88%

Antimicrobial Susceptibility and Genetic Characteristics of Streptococcus pneumoniae Isolates Indicating Possible Nosocomial Transmission Routes in a Community Hospital in Japan

Qin

Masaki²,

Watanabe

et al. 2007

J Clin Microbiol

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A clinical study was designed to study Streptococcus pneumoniae isolates recovered from a community hospital in Japan from April 2001 to November 2002. A total of 73 isolates were defined as derived from inpatient, outpatient, and hospital staff groups. The MIC results showed that 20 strains (27.4%) were susceptible to penicillin G, 39 strains (53.4%) had intermediate resistance, and 14 strains (19.2%) had full resistance. Low susceptibility to macrolides was also detected: 32.9%, 32.9%, and 34.2% of all strains were resistant to erythromycin, clarithromycin, and azithromycin, respectively. Thirty strains (41%) were resistant to at least two different kinds of antibiotics. Nineteen disparate serotypes were detected besides two nontypeable strains, and the predominant serotypes were 19F and 23F. Pulsed-field gel electrophoresis (PFGE) pattern A was dominant in the serotype 19F group; this pattern was similar to that of the international clone Taiwan 19F. A total of 10 different patterns were detected in the 23F group and were distinguishable from those of the international clones Spain 23F and Taiwan 23F. Pattern b strains were identified in the same ward, and pattern d strains were found both in patients with nosocomial pneumococcal infections (NPI) and in outpatients. In conclusion, drug-resistant S. pneumoniae was spreading rapidly, especially isolates of the serotype 19F and 23F groups. PFGE data revealed interpatient transmission and suggested that there might be some association between NPI patient strains and outpatient strains.

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“…Due to the severity of these infections and the difficulties in determining the bacterial etiology and the antimicrobial susceptibility, treatment is often empirical, consisting usually of orally administered agents. The choice of empiric antimicrobial chemotherapy is guided by the clinical presentation, the severity of the infection, and epidemiologic data, comprising the causative organisms and their susceptibility to antimicrobial agents [2, 3]. …”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance Trends among Community-Acquired Respiratory Tract Pathogens in Greece, 2009–2012

Maraki

Papadakis

2014

The Scientific World Journal

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The aim of the present study was to determine the antimicrobial resistance trends of respiratory tract pathogens isolated from patients with community-acquired respiratory tract infections (CARTIs) in Crete, Greece, over a 4-year period (2009–2012). A total of 588 community-acquired respiratory pathogens were isolated during the study period. Streptococcus pneumoniae was the most common organism responsible for 44.4% of CARTIs, followed by Haemophilus influenzae (44.2%) and Moraxella catarrhalis (11.4%). Among S. pneumoniae, the prevalence of isolates with intermediate- and high-level resistance to penicillin was 27.2% and 12.3%, respectively. Macrolide resistance slightly decreased from 29.4% over the period 2009-2010 to 28.8% over the period 2011-2012. Multiresistance was observed among 56 (54.4%) penicillin nonsusceptible isolates. A nonsignificant increase in resistance of H. influenzae isolates was noted for β-lactams, cotrimoxazole, and tetracycline. Among the 67 M. catarrhalis tested, 32 produced beta-lactamase and were resistant to ampicillin. Macrolide resistance decreased over the study period. All isolates were susceptible to amoxicillin + clavulanic acid, chloramphenicol, rifampicin, and the fluoroquinolones. Although a decreasing trend in the prevalence of resistance of the three most common pathogens involved in CARTIs was noted, continuous surveillance of antimicrobial susceptibility at the local and national level remains important, in order to guide appropriate empirical antimicrobial therapy.

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Community-acquired pneumonia: new management strategies for evolving pathogens and antimicrobial susceptibilities

Cited by 16 publications

References 99 publications

The Sentinel Project: an update on the prevalence of antimicrobial resistance in community-acquired respiratory Streptococcus pneumoniae and Haemophilus spp. in Italy

The Sentinel Project: an update on the prevalence of antimicrobial resistance in community-acquired respiratory Streptococcus pneumoniae and Haemophilus spp. in Italy

Antimicrobial Susceptibility and Genetic Characteristics of Streptococcus pneumoniae Isolates Indicating Possible Nosocomial Transmission Routes in a Community Hospital in Japan

Antimicrobial Resistance Trends among Community-Acquired Respiratory Tract Pathogens in Greece, 2009–2012

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