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[New microbiological data on the susceptibility of Pneumococci to levofloxacin]
1Service de bactériologie, Hôpital Henri Mondor, 94000 Créteil.
Abstract:
INCREASINGLY WIDESPREAD USE OF THE NEW FLUOROQUINOLONES: For the treatment of airway infections raises the risk of bacterial resistance, particularly for Streptococcus pneumoniae. IN FRANCE, PRESCRIPTIONS FOR QUINOLONES: Are much less frequent than in several other large countries. This is also true for anti-pneumococcal fluoroquinolones although prescriptions have increased moderately over the last year. FURTHER TO THE CONCERNS RESULTING: From the publication of two studies from Canada and Hong Kong in 1999 that suggested an increasing rate of fluoroquinolone resistant pneumocci, it has been established that the real rate of isolation of resistant strains remains very low, particularly in France, while the rate of penicillin and macrolide resistant strains has been more than 50% in most studies. S. PNEUMONIAE RESISTANCE: Basically results from chromosomal mutations that inhibit the affinity of fluoroquinolones for intrabacterial targets (topoisomerase i.v. and gyrase DNA), or increase active exflux. ALTHOUGH THE CURRENT OUTLOOK IS RATHER OPTIMISTIC: It is nevertheless indispensable to implement preventive measures for prescriptions and personal health care in order to limit the emergence and dissemination of fluoroquinolone-resistant penumococcal strains.
Insights
Widespread fluoroquinolone use risks bacterial resistance in Streptococcus pneumoniae. However, France shows low resistance rates, necessitating preventive measures to limit further spread.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Context:
- The increasing global use of fluoroquinolones for respiratory infections heightens concerns about bacterial resistance, especially in Streptococcus pneumoniae.
- France exhibits lower quinolone prescription rates compared to other nations, including for anti-pneumococcal fluoroquinolones, though a moderate increase was observed recently.
Purpose:
- To assess the prevalence of fluoroquinolone-resistant Streptococcus pneumoniae in France.
- To compare resistance rates to fluoroquinolones, penicillins, and macrolides in S. pneumoniae.
Summary:
- Despite concerns from international studies, fluoroquinolone-resistant pneumococcal strains remain rare in France.
- Penicillin and macrolide resistance rates in S. pneumoniae exceed 50% in most studies.
- Fluoroquinolone resistance in S. pneumoniae primarily stems from chromosomal mutations affecting drug targets or increasing efflux.
Impact:
- The current low resistance rates in France are optimistic but underscore the need for prudent antibiotic prescribing and healthcare practices.
- Implementing preventive strategies is crucial to mitigate the emergence and spread of fluoroquinolone-resistant pneumococcal strains.