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Resistance among Streptococcus pneumoniae: patterns, mechanisms, interpreting the breakpoints
Abstract:
Streptococcus pneumoniae is a frequent cause of respiratory tract infections. In the United States and worldwide, antimicrobial resistance of S pneumoniae has complicated the management of infections caused by this organism. In the United States, antimicrobial resistance with S pneumoniae has evolved almost entirely during the 1990s. Resistance currently exists at high rates with beta-lactams, macrolides, tetracyclines, chloramphenicol, and trimethoprim/sulfamethoxazole. Multiresistant strains--strains that are resistant to penicillin plus at least 2 other antimicrobial classes--are also increasing in prevalence. Fluoro-quinolone resistance remains at low levels in the United States. Control of the problem of antimicrobial resistance will require more judicious and appropriate use of antimicrobials, the development of new agents with novel targets of action, and strategies for preventing disease from occurring in the first place. In addition, the pursuit of an understanding of resistance mechanisms and pharmacodynamics as they relate to clinical outcome must be an ongoing effort, and that knowledge must be applied to the development of more effective approaches for the treatment of infections caused by S pneumoniae.
Insights
Antimicrobial resistance in Streptococcus pneumoniae is a growing concern, complicating respiratory infection treatment. New strategies and judicious antimicrobial use are crucial for effective management.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Streptococcus pneumoniae is a common cause of respiratory tract infections.
- Antimicrobial resistance in S. pneumoniae complicates treatment globally and in the United States.
- Resistance has significantly evolved since the 1990s.
Purpose of the Study:
- To summarize the current state of antimicrobial resistance in Streptococcus pneumoniae.
- To highlight the challenges posed by multidrug-resistant strains.
- To propose strategies for controlling antimicrobial resistance.
Main Methods:
- Review of existing literature on Streptococcus pneumoniae antimicrobial resistance patterns.
- Analysis of resistance trends in the United States and worldwide.
- Identification of antimicrobial classes with high resistance rates.
Main Results:
- High rates of resistance observed for beta-lactams, macrolides, tetracyclines, chloramphenicol, and trimethoprim/sulfamethoxazole.
- Increasing prevalence of multidrug-resistant strains.
- Fluoro-quinolone resistance remains low in the United States.
Conclusions:
- Judicious antimicrobial use and new drug development are essential.
- Disease prevention strategies are critical.
- Understanding resistance mechanisms and pharmacodynamics is key to effective treatment development.