Current microbiological aspects of community respiratory infection beyond COVID-19

Abstract

From a microbiological point of view, both empirical and targeted antimicrobial treatment in respiratory infection is based on the sensitivity profile of isolated microorganisms and the possible resistance mechanisms that they may present. The latter may vary in different geographic areas according to prescription profiles and vaccination programs. Beta-lactam antibiotics, fluoroquinolones, and macrolides are the most commonly used antimicrobials during the exacerbations of chronic obstructive pulmonary disease and community-acquired pneumonia. In their prescription, different aspects such as intrinsic activity, bactericidal effect or their ability to prevent the development of resistance must be taken into account. The latter is related to the PK/PD parameters, the mutant prevention concentration and the so-called selection window. More recently, the potential ecological impact has grown in importance, not only on the intestinal microbiota, but also on the respiratory one. Maintaining the state of eubiosis requires the use of antimicrobials with a low profile of action on anaerobic bacteria. With their use, the resilience of the bacterial populations belonging to the microbiota, the state of resistance of colonization and the collateral damage related to the emergence of resistance to the antimicrobials in pathogens causing the infections and in the bacterial populations integrating the microbiota.

Sex-Related Disparities in the Incidence and Outcomes of Community-Acquired Pneumonia among Type 2 Diabetes Patients: A Propensity Score-Matching Analysis Using the Spanish National Hospital Discharge Database for the Period 2016–2019

“…Spanish authors have suggested that, besides year-to-year variability, the increase in bacterial and viral isolations over time might reflect a changing epidemiology due to a potential increase in patients with worse socio-sanitary conditions or with previous antimicrobial therapy and to an improvement over time in microbiological surveillance with a higher proportion of patients with samples being collected and improved microbiological diagnostic technologies [40,41,43]. Further evaluation of the impact of pneumococcal vaccination on adult CAP is necessary in our country.…”

Oral antibiotic treatment of exacerbation of COPD. Beyond COVID-19

“…En este apartado abordaremos tres aspectos básicos para la adecuada selección de antibióticos orales en las EAEPOC que son la efectividad, los efectos adversos y el impacto sobre la microbiota, incluyendo la emergencia y selección de resistencias [16,17]. a) Efectividad del antibiótico.…”

“…En el caso de las cefalosporinas intravenosas de 3ª generación, la terapia secuencial más adecuada es cefditoreno por presentar similar espectro y actividad intrínseca [27]. Los beneficios de la estrategia secuencial son directos tanto para el paciente (mayor confort, alta precoz y menor riesgo de infección nosocomial), como para el sistema sanitario (reducción de la estancia hospitalaria y de los costes) [17]. Para cumplir este doble objetivo es preciso asegurar varios puntos: similar espectro bacteriano, buena biodisponibilidad, tolerancia gastrointestinal y baja selección de mutantes resistentes en el tubo digestivo.…”

The Search for New Antibacterial Agents among 1,2,3-Triazole Functionalized Ciprofloxacin and Norfloxacin Hybrids: Synthesis, Docking Studies, and Biological Activity Evaluation

“…Recently, the authors of [9] reported that the fluoroquinolones-levofloxacin and moxifloxacin-are the most commonly used antimicrobial agents for the treatment of chronic obstructive pulmonary disease and community-acquired pneumonia. Noteworthy, they not only reveal wide antimicrobial activity, but also possess antiviral action against vaccinia virus, papovavirus, CMV, VZV, HSV-1, HSV-2, HCV, and HIV [10].…”