Antibiotic Resistance of Pathogens Causing Community-Acquired Pneumonia

Abstract

SUMMARYCommunity-acquired pneumonia remains an important cause of disease and death both in the developed and the developing worlds and therefore continues to have major medical impact. The mortality remains high despite the ready availability of potent antimicrobial 2 agents to which the organisms are susceptible. However, management of these infections is potentially complicated by the emerging resistance of many of the common pathogens to the different classes of antibiotics that are usually prescribed. Furthermore, it is also being recognized that antibiotic resistance and/or treatment failures may occur not only through traditional microbial antibiotic resistance mechanisms, but also through less well-defined mechanisms, particularly those developed by the microbes in relation to their quorum sensing/biofilm machinery. Much recent research in this field has been focused on evaluating the clinical impact of antibiotic resistance on optimal antibiotic treatment and antimicrobial choices, as well as alternative strategies to deal with antibiotic resistance and/or treatment failures.

Recent advances in our understanding of Streptococcus pneumoniae infection

“…Management of pneumococcal infections is potentially being compromised by increasing resistance of the pathogen to antibiotics commonly used to treat these infections [3-5]. However, there has been considerable debate about the true impact of current levels of antibiotic resistance, particularly intermediate resistance, on the outcome of pneumococcal infections in patients treated with the different antibiotic classes.…”

“…However, there has been considerable debate about the true impact of current levels of antibiotic resistance, particularly intermediate resistance, on the outcome of pneumococcal infections in patients treated with the different antibiotic classes. In the case of pneumococcal meningitis, poorer outcomes are much more likely to occur in the presence of antimicrobial resistance; however, the situation is less clear-cut with infections such as pneumonia [3]. In general, most researchers suggest that, in the case of community-acquired pneumonia (CAP), the use of appropriate β-lactam agents in adequate doses is unlikely to be associated with a poorer outcome but that this is not the case with regard to macrolide resistance (particularly high-level macrolide resistance) or with regard to fluoroquinolone resistance, in which failure of antibiotic therapy in patients treated with these classes of agents in the presence of antibiotic resistance is much more likely to occur [3-5].…”

HIV-Associated Bacterial Pneumonia

“…Most cases of severe H.influenzae infection in HIV-infected persons occurring with advanced immunosuppression involve non-typeable strains of this pathogen [42]. Accordingly, immunization of adults, unlike children, with H.influenzae type B (Hib) conjugate vaccine is not recommended [82,83], although this situation may change with the development of novel vaccines based on conserved surface proteins [85].…”

Prevalence and Antibiotic Resistance Pattern of Streptococcus Pneumoniae, Isolated From Invasive and Non-Invasive Infections in a Tertiary Care Hospital of Karachi.

“…A number of significant challenges remain with regards to the diagnosis, treatment, and prevention of pneumococcal infections [6]. Treatment strategies against pneumococcal infections have been compromised by the emergence of increasing resistance of the pathogen to commonly used antibiotics [13][14][15]. This study discusses the prevalence and antibiotic susceptibility pattern of S. pneumoniae isolated from different clinical samples from a tertiary care hospital of Karachi.…”