2009
DOI: 10.1055/s-0029-1202939
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Abstract: Over the past 3 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 109 publications
(81 citation statements)
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References 246 publications
(696 reference statements)
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“…These investigators also reported that six serotypes (6A, 6B, 9V, 14, 19F, 23F) account for >80% of penicillin-or macrolide-resistant S. pneumoniae, worldwide. 9 Moreover in the US, an increase in the isolation of antibiotic resistant 19A strains has been reported, a strain associated with increased incidence of IPD. 10 Effective immunization against S. pneumoniae is the most effective method to reduce the impact of pneumococcal infections, including those caused by antibiotic resistant strains.…”
Section: Discussionmentioning
confidence: 99%
“…The disease burden of pneumococcal infections has increased due to widespread emergence of antimicrobial resistance in many countries during the past few decades (17). Previous reports documented very high prevalence rates of beta-lactam and macrolide resistance in S. pneumoniae in Asian countries (6,7,11).…”
mentioning
confidence: 99%
“…Previous reports documented very high prevalence rates of beta-lactam and macrolide resistance in S. pneumoniae in Asian countries (6,7,11). Particularly, erythromycin resistance has remarkably increased in many Asian countries, where Ͼ70% of clinical isolates were fully resistant (17,23,24). A previous surveillance study by the Asian Network for Surveillance of Resistant Pathogens (ANSORP) showed that 53.1% of pneumococcal isolates from Asian countries, up to 92% in Vietnam, were resistant to erythromycin (23).…”
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confidence: 99%
“…Using the 2008 CLSI penicillin breakpoints, the majority of strains (94%) was susceptible, as opposed to 69% using the previous breakpoints. Strikingly, 10.6% of the strains were resistant to levofloxacin, in contrast to only 2% in 2008, a percentage that has never been observed in Spain before and is rare in other countries (6,8,9). Resistance against penicillin, erythromycin, and levofloxacin was predominantly seen in serotype 19A.…”
mentioning
confidence: 91%
“…In the past decade, the emergence and spread of resistant Streptococcus pneumoniae strains has caused major concern, and elucidation of the genetic mechanisms involved in the dissemination of drug resistance has become an important subject for study (11). The non-beta-lactam multidrug resistance in S. pneumoniae is related to the Tn916 family of transposons; however, not much is known about their prevalence in different geographical regions.…”
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confidence: 99%