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Pneumococcal drug resistance: the new "special enemy of old age"
1Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. jcb3@cdc.gov
Abstract:
Streptococcus pneumoniae is a leading cause of illness and death among the elderly. The recent emergence of drug-resistant strains has complicated selection of antimicrobial therapy for suspected pneumococcal infections. In some areas of North America, nearly 40% of pneumococcal isolates from the blood or cerebrospinal fluid of persons > or = 65 years old had reduced susceptibility to penicillin. Of all penicillin-resistant infections, >30% occur in persons > or = 65 years old. The increasing prevalence of drug-resistant pneumococci and recent outbreaks of pneumococcal disease in chronic-care facilities emphasize the importance of efforts to prevent these infections in the elderly. Limiting selection for drug-resistant strains through judicious use of antimicrobial drugs and preventing invasive pneumococcal infections through increased use of pneumococcal vaccine form the foundation of these efforts.
Insights
Drug-resistant Streptococcus pneumoniae infections are a growing threat to older adults. Prevention strategies, including responsible antibiotic use and increased pneumococcal vaccination, are crucial for combating these serious illnesses.
Area of Science:
- Infectious Diseases
- Geriatrics
- Antimicrobial Resistance
Background:
- Streptococcus pneumoniae poses a significant health risk, particularly for the elderly population.
- The rise of antibiotic-resistant strains complicates treatment decisions for pneumococcal infections.
- Penicillin-resistant pneumococcal isolates are increasingly detected in elderly individuals, with nearly 40% showing reduced susceptibility in some North American regions.
Purpose of the Study:
- To highlight the growing challenge of drug-resistant Streptococcus pneumoniae in the elderly.
- To emphasize the need for effective prevention strategies against pneumococcal disease in older adults.
Main Methods:
- Review of existing data on pneumococcal resistance patterns in elderly populations.
- Analysis of infection prevalence and resistance trends in individuals aged 65 and older.
Main Results:
- Over 30% of penicillin-resistant pneumococcal infections occur in individuals aged 65 and older.
- Drug-resistant pneumococci are a growing concern, evidenced by recent outbreaks in long-term care facilities.
Conclusions:
- Preventing invasive pneumococcal infections in the elderly is paramount.
- Key strategies include judicious antimicrobial drug use to limit resistance and increased pneumococcal vaccination rates.