2005
DOI: 10.1055/s-2005-925524
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Abstract: Over the past 2 decades, antimicrobial resistance among Streptococcus pneumoniae, the most common cause of community-acquired pneumonia (CAP), has escalated dramatically worldwide. In the late 1970s, strains of pneumococci displaying resistance to penicillin were described in South Africa and Spain. By the early 1990s, penicillin-resistant clones of S. pneumoniae spread rapidly across Europe and globally. Additionally, resistance to macrolides and other antibiotic classes escalated in tandem with penicillin re… Show more

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Cited by 66 publications
(108 citation statements)
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References 415 publications
(1,230 reference statements)
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“…Penicillin-resistant isolates were first detected in the late 1960s, and their prevalence increased rapidly during the 1980s. Since 1989, the incidence of penicillin-resistant pneumococci has remained fairly constant at about 20-30 % of all isolates (Lynch & Zhanel, 2005). Molecular characterization of penicillinresistant strains from around the world has highlighted an important diversity among isolates, but has also identified a number of successful pneumococcal clones with a high level of penicillin resistance, some of which have spread globally (Crook & Spratt, 1998).…”
Section: Introductionmentioning
confidence: 99%
“…The emergence of antibiotic-resistant strains of this micro-organism has further underlined the need for providing effective prophylactic vaccination (Bridy-Pappas et al, 2005;Lynch & Zhanel, 2005).…”
Section: Introductionmentioning
confidence: 99%
“…In spite of the availability of antimicrobials, the capsular polysaccharide (PS) vaccine, and the 7-valent protein-PS conjugate vaccine, pneumococcal disease continues to cause high morbidity and mortality worldwide, especially in groups at high risk, such as children under 2 years of age, the elderly, and immunocompromised individuals (36). These continuing pneumococcal disease problems have arisen in part due to the increasing rates at which S. pneumoniae is acquiring resistance to multiple antimicrobials (27) but are largely due to the shortcomings associated with the current capsular-based vaccines, including high cost, serotype-specific protection, limited serotype coverage, and the likelihood of a concomitant increase in carriage, and subsequently disease, with nonvaccine serotypes. Consequently, concerted global efforts are currently focused on developing alternative pneumococcal-vaccine strategies that address these shortcomings, without compromising efficacy.…”
mentioning
confidence: 99%
“…The burden of pneumococcal infection is particularly large among children and the elderly and is exacerbated by the rising numbers of isolates resistant to antibiotics (36). In developing countries, at least a million deaths per annum among children under 5 years of age are attributed to pneumococcal pneumonia (63a).…”
mentioning
confidence: 99%
“…The use of antibiotics has increased the bacterial resistance to common pathogens such as SP, and resistance rates as high as 40% are reported in some parts of the world. [12][13][14][15] In the United States, SP resistance to penicillin has been recorded as high as 40% for respiratory isolates, while macrolide resistance to SP is at approximately 12% and increasing. 16 In Canada, SP resistance to penicillin has been recorded as high as 30% for respiratory isolates, 16 while macrolide resistance to SP is in the range of 8%-10%.…”
Section: Discussionmentioning
confidence: 99%