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Surveillance of resistance in bacteria causing community-acquired respiratory tract infections
David Felmingham1, C Feldman, W Hryniewicz
1GR Micro Ltd, London, UK. d.felmingham@grmicro.co.uk
Abstract:
Bacterial resistance to antibiotics in community-acquired respiratory tract infections is a serious problem and is increasing in prevalence world-wide at an alarming rate. Streptococcus pneumoniae, one of the main organisms implicated in respiratory tract infections, has developed multiple resistance mechanisms to combat the effects of most commonly used classes of antibiotics, particularly the beta-lactams (penicillin, aminopenicillins and cephalosporins) and macrolides. Furthermore, multidrug-resistant strains of S. pneumoniae have spread to all regions of the world, often via resistant genetic clones. A similar spread of resistance has been reported for other major respiratory tract pathogens, including Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes. To develop and support resistance control strategies it is imperative to obtain accurate data on the prevalence, geographic distribution and antibiotic susceptibility of respiratory tract pathogens and how this relates to antibiotic prescribing patterns. In recent years, significant progress has been made in developing longitudinal national and international surveillance programs to monitor antibiotic resistance, such that the prevalence of resistance and underlying trends over time are now well documented for most parts of Europe, and many parts of Asia and the Americas. However, resistance surveillance data from parts of the developing world (regions of Central America, Africa, Asia and Central/Eastern Europe) remain poor. The quantity and quality of surveillance data is very heterogeneous; thus there is a clear need to standardize or validate the data collection, analysis and interpretative criteria used across studies. If disseminated effectively these data can be used to guide empiric antibiotic therapy, and to support-and monitor the impact of-interventions on antibiotic resistance.
Insights
Antibiotic resistance in respiratory infections is a growing global threat. Accurate surveillance data on bacterial resistance is crucial for effective antibiotic stewardship and control strategies worldwide.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Antibiotic resistance in community-acquired respiratory tract infections (RTIs) is a significant and escalating global health concern.
- Key respiratory pathogens like Streptococcus pneumoniae exhibit widespread resistance to common antibiotic classes, including beta-lactams and macrolides.
- Multidrug-resistant strains are disseminated globally, necessitating robust monitoring.
Purpose of the Study:
- To highlight the critical need for accurate data on the prevalence, geographic distribution, and antibiotic susceptibility of respiratory pathogens.
- To emphasize the importance of linking resistance patterns to antibiotic prescribing practices for effective control strategies.
- To underscore the necessity of standardized data collection and analysis for global antibiotic resistance surveillance.
Main Methods:
- Review of existing longitudinal national and international surveillance programs for antibiotic resistance.
- Analysis of reported prevalence and trends of resistance in major respiratory tract pathogens.
- Identification of gaps in surveillance data, particularly in developing regions.
Main Results:
- Significant progress in resistance surveillance exists for Europe, Asia, and the Americas.
- Surveillance data from Central America, Africa, Asia, and Central/Eastern Europe remain inadequate.
- Heterogeneity in the quantity and quality of available surveillance data is a major limitation.
Conclusions:
- Accurate and comprehensive antibiotic resistance data are imperative for developing and supporting effective resistance control strategies.
- Standardization and validation of data collection, analysis, and interpretation are essential for reliable global surveillance.
- Dissemination of reliable data can guide empiric antibiotic therapy and monitor intervention impacts.