Related Experiment Videos
[Clinical study on penicillin insusceptible/resistant Streptococcus pneumoniae in the elderly patients]
K Takahira1, H Kataoka, Y Masuda
1Tokyo Metropolitan Geriatric Medical Center.
Abstract:
Clinical features of respiratory infection in the elderly with penicillin insusceptible (31 cases) and resistant (7 cases) Streptococcus pneumonia (PSSP/PRSP) are compared to those with penicillin sensitive S. pneumoniae (PSSP) (29 cases). Incidence of bacteremia and pneumonia was higher in the PSSP group. PISP/PRSP tend to be isolated from patients with bronchitis underlaid with chronic pulmonary disease without statistic significance. Efficacy of the penicillins and 1st and 2nd generation cephem was satisfactory except in only one case of pneumonia with PISP which needed an alternative choice to the 3rd generation cephem. Now a day the degree of resistance is not so high and the available antibiotics are sufficient for the treatment of pneumococcal infection in the elderly patients. However, the wide use of oral cephems and certain new quinolones which do not have enough activity against Streptococcus pneumoniae may increase resistance. In which case, continuous surveillance and clinical caution against this resistant strain is necessary.
Insights
Clinical features of respiratory infections in elderly patients caused by penicillin-resistant Streptococcus pneumoniae were compared. While current antibiotics are effective, vigilance against rising resistance is crucial for elderly patients.
Area of Science:
- Infectious Diseases
- Microbiology
- Geriatrics
Context:
- Elderly patients are susceptible to Streptococcus pneumoniae infections.
- Penicillin-insusceptible and resistant strains of Streptococcus pneumoniae (PISP/PRSP) pose a growing concern.
- Understanding clinical features and treatment outcomes is vital for effective patient management.
Purpose:
- To compare clinical features of respiratory infections in elderly patients with penicillin-sensitive (PSSP) versus penicillin-insusceptible/resistant (PISP/PRSP) Streptococcus pneumoniae.
- To evaluate the efficacy of common antibiotics against these strains in the elderly.
- To assess the current level of antibiotic resistance and recommend future surveillance strategies.
Summary:
- A comparative study analyzed 67 elderly patients with Streptococcus pneumoniae respiratory infections, categorizing them by penicillin susceptibility.
- Incidence of bacteremia and pneumonia was higher in the penicillin-sensitive group. PISP/PRSP were more frequently isolated in patients with underlying chronic pulmonary disease.
- Penicillins and early-generation cephems showed satisfactory efficacy, with only one PISP pneumonia case requiring a switch to third-generation cephems. Current resistance levels are manageable, but emerging resistance necessitates ongoing monitoring.
Impact:
- Provides insights into the clinical presentation and antibiotic response for pneumococcal infections in the elderly.
- Highlights the need for continued surveillance of Streptococcus pneumoniae resistance patterns.
- Informs clinical decision-making regarding antibiotic selection for elderly patients with respiratory infections.