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Antimicrobial resistance in Streptococcus pneumoniae: implications for patients with community-acquired pneumonia

C E Chenoweth1, S Saint, F Martinez

  • 1Department of Internal Medicine, University of Michigan Health System, Ann Arbor 48109-0378, USA. cchenow@umich.edu

Mayo Clinic Proceedings
|November 15, 2000
PubMed

Insights

Antibiotic resistance in Streptococcus pneumoniae, a common cause of pneumonia, is rising. This trend impacts treatment choices for bacterial pneumonia, necessitating careful consideration of local resistance patterns.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Streptococcus pneumoniae is a primary cause of community-acquired pneumonia (CAP).
  • Significant increases in penicillin resistance among S. pneumoniae strains have been observed globally.
  • Resistance to other antimicrobials like cephalosporins, macrolides, and trimethoprim-sulfamethoxazole is also a growing concern.

Purpose of the Study:

  • To provide an overview of the emergence and spread of antibiotic resistance in Streptococcus pneumoniae.
  • To discuss the clinical implications of antimicrobial resistance in S. pneumoniae for treating pneumonia.
  • To highlight the importance of local resistance patterns in guiding empirical antibiotic therapy.

Main Methods:

  • Review of existing literature on Streptococcus pneumoniae antibiotic resistance.
  • Analysis of resistance trends for commonly used antimicrobial agents.
  • Discussion of treatment strategies for susceptible and resistant S. pneumoniae infections.

Main Results:

  • Penicillin resistance rates in S. pneumoniae have risen dramatically, reaching up to 45% in some US regions.
  • S. pneumoniae has developed resistance to multiple antibiotic classes, including cephalosporins, macrolides, and trimethoprim-sulfamethoxazole.
  • While vancomycin and quinolones remain largely active, reduced susceptibility has been noted in some strains.

Conclusions:

  • Prior antimicrobial use is a key factor driving the development of resistant S. pneumoniae strains.
  • Beta-lactam antibiotics are preferred for susceptible S. pneumoniae infections, but optimal treatment for resistant strains is still under investigation.
  • Empirical treatment decisions for CAP must consider community-specific S. pneumoniae resistance patterns.

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