Resistance to Penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain

Pallarés, Román; Liñares, Josefina; Vadillo, Miquel; Cabellos, Carmen; Manresa, F.; Viladrich, Pedro F.; Martin, R. Russell; Gudiol, Francesc

doi:10.1056/nejm199508243330802

Cited by 689 publications

(369 citation statements)

References 36 publications

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“…However, retrospective and prospective studies in adult and pediatric populations showed that the outcomes of pneumococcal pneumonias caused by purportedly resistant strains but treated with penicillin antibiotics did not differ from those obtained with other antimicrobial agents, suggesting that meningitis breakpoints did not apply to pneumonia. [12][13][14] Later multicenter studies confirmed these results. 15,16 On the basis of these findings and of a review and S. pneumoniae strains were isolated from blood cultures using the BacT/ALERT ® detection system (Biomérieux, France), whereas pleural fluid specimens were cultured on chocolate agar and sheep blood agar (Biomérieux, Rio de Janeiro, Brazil).…”

Section: Introductionmentioning

confidence: 67%

Análise das cepas de Streptococcus pneumoniae causadores de pneumonia invasiva: sorotipos e sensibilidade aos antimicrobianos

Yoshioka¹,

Martinez²,

Brandileone³

et al. 2011

J. Pediatr. (Rio J.)

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Objectives: To identify the most common pneumococcal serotypes in children hospitalized with invasive pneumonia, correlate isolated serotypes with those included in conjugate vaccines, and ascertain the sensitivity of the isolated pneumococcal strains to penicillin and other antibiotics. Methods:From January 2003 to October 2008, a retrospective study of hospitalized children with a diagnosis of Streptococcus pneumoniae pneumonia was conducted at the university hospital of Universidade de São Paulo. Criteria for inclusion were: age greater than 29 days and less than 15 years, radiological and clinical diagnosis of pneumonia, and isolation of Streptococcus pneumoniae in blood cultures and/or pleural effusion. Results:The study included 107 children. The most common serotypes were 14 (36.5%), 1 (16%), 5 (14.6%), 6B (6.3%) and 3 (4.2%). The proportion of identified serotypes contained in the heptavalent, 10-valent and 13-valent conjugate vaccines was 53.1, 86.5, and 96.9%, respectively. Pneumococcal strains were sensitive to penicillin (minimum inhibitory concentration, MIC ≤ 2 μg/mL) in 100 cases (93.5%) and displayed intermediate resistance (MIC = 4 μg/mL) in 7 cases (6.5%). No strains were penicillin-resistant (MIC ≥ 8 µg/mL) according to the Clinical and Laboratory Standards Institute 2008 standards. Tested isolates were highly sensitive to vancomycin, rifampicin, ceftriaxone, clindamycin, erythromycin, and chloramphenicol. Conclusions:Our results confirm a significant potential impact of conjugate vaccines, mainly 10-valent and 13-valent, on invasive pneumonia. Furthermore, susceptibility testing results show that penicillin is still the treatment of choice for invasive pneumonia in our setting.J Pediatr (Rio J). 2011;87(1):70-75: Streptococcus pneumoniae, pneumonia, serotype, antimicrobial resistance, pneumococcal conjugate vaccine.

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Section: Introductionmentioning

confidence: 67%

Análise das cepas de Streptococcus pneumoniae causadores de pneumonia invasiva: sorotipos e sensibilidade aos antimicrobianos

Yoshioka¹,

Martinez²,

Brandileone³

et al. 2011

J. Pediatr. (Rio J.)

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“…(22) There are conflicting data on whether this type of resistance correlates with clinical failure among patients with invasive pneumococcal disease treated with macrolide antibiotics. (7,9,10,13,17,23,24) The strongest predictor of macrolide resistance among patients with pneumococcal bacteremia was prior antibiotic use. Patients who have received > 24 hours of antibiotics therapy at the time the blood culture was drawn were four times more likely to harbor a macrolide resistant organism, compared to those not receiving prior antibiotic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…There is literature suggesting that antibiotic resistance may contribute to treatment failure and poor clinical outcomes. (7,(9)(10)(11) Cases of failed therapy in association with resistance have been reported, but large-scale clinical studies of this phenomenon are lacking. The result is poor consensus regarding the clinical implications of antimicrobial resistance.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Antimicrobial Resistance and Mortality in Pneumococcal Bacteremia

Neuman

Kelley

Harper

et al. 2007

The Journal of Emergency Medicine

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We conducted a multicenter, retrospective cohort study of patients with Streptococcus pneumoniae bacteremia to determine factors associated with antibiotic resistance and mortality. Risk factors were identified using multivariate logistic regression. 1,574 patients at 34 sites were enrolled. Compared to isolates from patients not receiving an antibiotic before the index blood culture, patients receiving an antibiotic were less likely to harbor an antibiotic susceptible organism. Susceptibility to penicillin decreased from 78% (95% confidence interval [CI], 75−80) to 49% (95%CI, 39−59); to cefotaxime/ ceftriaxone, from 92% (95%CI, 90−93) to 82% (95%CI, 72−89); and to macrolide, from 84% (95% CI, 82−87) to 55% (95%CI, 41−68). Factors associated with macrolide non-susceptibility include: >24 hours of antibiotic therapy at time of the index culture (odds ratio [OR] 4.0), residing in southern U.S. (OR 1.7), and having an antibiotic allergy (OR 1.7). Harboring an antibiotic non-susceptible strain (OR 1.4) and male sex (OR 1.4) were associated with increased risk of mortality, whereas Black race (OR 0.6) and evidence of focal infection (OR 0.6) were associated with decreased risk.

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“…A diferencia de varios reportes internacionales 12,13 , en el curso de nueve años no hemos observado tendencia al aumento en la frecuencia de cepas con resistencia a PNC. Durante el año 2003, las cepas de susceptibilidad disminuida a la PNC alcanzaron a 13,7%, cifra similar a la ya observada los años 2000 y 1997.…”

Section: Discussionunclassified

Susceptibilidad a penicilina en cepas de Streptococcus pneumoniae aisladas en el Hospital de Puerto Montt, 1995-2003

Z¹,

O²

2006

Rev. méd. Chile

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Resistance to Penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain

Abstract: Current levels of resistance to penicillin and cephalosporin by S. pneumoniae are not associated with increased mortality in patients with pneumococcal pneumonia. Hence, these antibiotics remain the therapy of choice for this disease.

Cited by 689 publications

References 36 publications

Análise das cepas de Streptococcus pneumoniae causadores de pneumonia invasiva: sorotipos e sensibilidade aos antimicrobianos

Análise das cepas de Streptococcus pneumoniae causadores de pneumonia invasiva: sorotipos e sensibilidade aos antimicrobianos

Factors Associated With Antimicrobial Resistance and Mortality in Pneumococcal Bacteremia

Susceptibilidad a penicilina en cepas de Streptococcus pneumoniae aisladas en el Hospital de Puerto Montt, 1995-2003

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