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[Pneumonia caused by resistant pneumococci]

P Léophonte1, M Mularczyk, P Geslin

  • 1Service de Pneumologie et Allergologie, Hôpital de Rangueil, Toulouse.

Presse Medicale (Paris, France : 1983)
|May 29, 1993
PubMed
Summary
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Antibiotic resistance in pneumococci is a growing global concern, particularly in Europe. Penicillin resistance in France rose significantly, with specific stereotypes and risk factors identified.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Context:

  • Acquired antibiotic resistance in Streptococcus pneumoniae is a significant and increasing global health issue.
  • Resistance patterns are unevenly distributed, with notable prevalence in specific European countries like Spain and Hungary.
  • In France, penicillin resistance in pneumococci rose from under 5% in 1988 to 16.9% in 1991, highlighting a rapid increase.

Purpose:

  • To analyze the prevalence and characteristics of antibiotic-resistant pneumococcal strains.
  • To identify risk factors associated with penicillin resistance in pneumococci.
  • To evaluate current and alternative treatment strategies and preventive measures.

Summary:

  • Over 80% of resistant pneumococcal strains belong to four stereotypes (6, 9, 19, 23), with stereotype 23F being predominant (>50%).

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  • Previous beta-lactam antibiotic treatment is a major risk factor; frequent pneumonias, nosocomial infections, and recent hospitalizations are also implicated.
  • High-dose amoxicillin is recommended for intermediate resistance (MIC 0.1-1.0 µg/ml), while ceftriaxone, cefotaxime, or imipenem are needed for higher MICs. Pristinamycin shows good in vitro activity.

    • Impact:

    • Understanding resistance patterns and risk factors is crucial for effective treatment and public health strategies.
    • Prevention strategies include patient isolation, treatment of carriers, and widespread pneumococcal vaccination.
    • The findings underscore the need for continued surveillance and development of new therapeutic approaches against resistant pneumococci.