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[Epidemiology of resistance to antibiotics in respiratory tract infections]

C Muller-Serieys1

  • 1Laboratoire de Bactériologie, Groupe Hospitalier Bichat-Claude Bernard, Paris. claudette.muller@bch.ap-hop-paris.fr

Presse Medicale (Paris, France : 1983)
|December 22, 1999
PubMed

Insights

Antibiotic resistance in common respiratory pathogens like Streptococcus pneumoniae is a growing global concern. Understanding resistance patterns is crucial for effective empirical treatment of infections.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Antibiotic resistance is a significant challenge for common respiratory pathogens, including Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes, and Moraxella catarrhalis.
  • These bacteria are frequently treated with beta-lactamines, fluoroquinolones, and macrolides, and resistance to these drug classes is increasing globally.
  • High incidences of resistance have been reported in various countries, necessitating a re-evaluation of treatment strategies.

Purpose of the Study:

  • To review the current landscape of antibiotic resistance in key respiratory tract pathogens.
  • To highlight the mechanisms and prevalence of resistance to beta-lactamines, fluoroquinolones, and macrolides.
  • To emphasize the importance of epidemiological data and local bacterial ecology in guiding empirical treatment decisions for respiratory infections.

Main Methods:

  • Review of existing literature on antibiotic resistance patterns.
  • Analysis of resistance mechanisms, including enzymatic processes (penicillinase production) and target modification (DNA gyrase, topoisomerases).
  • Examination of genetic determinants of resistance, such as erm and mef genes.

Main Results:

  • Penicillin resistance in Streptococcus pneumoniae is geographically widespread and particularly high in France.
  • Haemophilus influenzae and Moraxella catarrhalis exhibit significant amino-penicillin resistance due to penicillinase production.
  • Fluoroquinolone resistance in Haemophilus influenzae, though rare, is concerning, indicating bacterial adaptation. Streptococci also show increasing fluoroquinolone resistance.
  • Macrolide resistance in streptococci is mediated by erm or mef genes, with varying prevalence and mechanisms globally.

Conclusions:

  • Antibiotic resistance in respiratory pathogens is an evolving problem requiring continuous monitoring.
  • Resistance patterns vary significantly by geographic location and bacterial species.
  • Empirical antibiotic treatment for respiratory tract infections must consider local epidemiological data and bacterial ecology.

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