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Predicting antimicrobial resistance in invasive pneumococcal infections

Otto G Vanderkooi1, Donald E Low, Karen Green

  • 1Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|April 13, 2005
PubMed
Abstract

Insights

Previous antibiotic use and lack of chronic disease increase the risk of drug-resistant Streptococcus pneumoniae infections. Identifying these risk factors helps clinicians choose effective treatments for pneumococcal infections.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Increasing global prevalence of multi-antimicrobial resistance in Streptococcus pneumoniae.
  • Need for identifying risk factors for antibiotic-resistant pneumococcal isolates to guide empirical therapy.

Purpose of the Study:

  • To evaluate risk factors associated with antimicrobial resistance in invasive pneumococcal infections.
  • To inform clinical decision-making for empirical treatment of pneumococcal infections.

Main Methods:

  • Prospective cohort study of invasive pneumococcal infections in Toronto, Canada.
  • Univariate and multivariate modeling to assess risk factors for antimicrobial resistance.

Main Results:

  • Previous use of penicillin, trimethoprim-sulfamethoxazole (TMP-SMX), and azithromycin were associated with resistance to these agents.
  • Absence of chronic organ system disease was a risk factor for penicillin- and TMP-SMX-resistant pneumococci.
  • Nursing home residence and nosocomial acquisition were significant risk factors for fluoroquinolone-resistant pneumococci.

Conclusions:

  • Antimicrobial use within 3 months prior to infection is critical for selecting appropriate therapy for Streptococcus pneumoniae.
  • Nosocomial and nursing home acquisition are key risk factors for fluoroquinolone-resistant pneumococcal infections.

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