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Antibiotic-resistant pneumococci
1Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Abstract:
Antibiotic-resistant pneumococci are increasing in prevalence in the United States and are present in numerous areas of the country. Simple screening methods available to identify penicillin-resistant strains and improved national surveillance programs should give more accurate data on the frequency that these resistant pneumococci are causing disease. It is logical to assume that, as the prevalence of nasopharyngeal carriage of these strains increases, more and more invasive infections in children will be caused by antibiotic-resistant pneumococci in the future. The treatment of invasive infections, particularly meningitis, caused by penicillin-resistant and multiply resistant strains, and the treatment of AOM caused by pneumococci resistant to all currently available oral preparations remains problematic. Controlled studies are necessary to determine optimal antimicrobials or other interventions necessary to treat these infections. Finally, prevention of colonization and subsequent infection by the pneumococcus assumes new urgency as antimicrobial resistance spreads. Potentially effective vaccines, such as the new polysaccharide-protein conjugate vaccines that will have efficacy in small children, are currently in early field trials and ultimately may be the best mechanism to deal with the spread of these organisms.
Insights
Antibiotic-resistant pneumococci are a growing public health concern in the US. Increased carriage of these resistant strains may lead to more invasive infections, posing treatment challenges and highlighting the need for new prevention strategies like vaccines.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Increasing prevalence of antibiotic-resistant *Streptococcus pneumoniae* in the United States.
- Need for accurate data on disease frequency caused by resistant pneumococci.
- Rising nasopharyngeal carriage of resistant strains is predicted to increase invasive infections in children.
Purpose of the Study:
- To address the challenges in treating invasive pneumococcal infections, particularly meningitis and otitis media (AOM), caused by resistant strains.
- To emphasize the urgency of preventing pneumococcal colonization and infection due to spreading antimicrobial resistance.
- To highlight the potential role of novel conjugate vaccines in combating resistant pneumococci.
Main Methods:
- Utilizing simple screening methods for penicillin-resistant strains.
- Leveraging improved national surveillance programs for data collection.
- Conducting controlled studies to determine optimal treatment interventions.
Main Results:
- Penicillin-resistant and multiply resistant pneumococcal strains present significant treatment challenges for invasive infections.
- Pneumococci resistant to currently available oral antibiotics complicate the treatment of otitis media (AOM).
- Emerging antibiotic resistance necessitates urgent preventive measures.
Conclusions:
- Effective treatment strategies for invasive infections caused by resistant pneumococci are still needed.
- Prevention of pneumococcal colonization and infection is critical.
- Polysaccharide-protein conjugate vaccines show promise for preventing infections in young children and combating resistance spread.