Appelbaum Peter C
Departments of Pathology and Clinical Microbiology, Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA.
Clin Infect Dis. 2002 Jun 15;34(12):1613-20. doi: 10.1086/340400. Epub 2002 May 16.
Streptococcus pneumoniae is an important pathogen in many community-acquired respiratory infections in the United States and a leading cause of morbidity and mortality worldwide. Unfortunately, S. pneumoniae is becoming increasingly resistant to a variety of antibiotics. Results of recent surveillance studies in the United States show that the prevalence of penicillin-nonsusceptible S. pneumoniae ranges from 25% to >50%, and rates of macrolide resistance among pneumococci are reported to be as high as 31%. A high prevalence of resistance to other antimicrobial classes is found among penicillin-resistant strains. Newer quinolones (e.g., gatifloxacin, gemifloxacin, and moxifloxacin) that have better antipneumococcal activity in vitro are the most active agents and therefore are attractive options for treatment of adults with community-acquired respiratory infections. Efforts should be made to prevent pneumococcal infections in high-risk patients through vaccination.
肺炎链球菌是美国许多社区获得性呼吸道感染中的重要病原体，也是全球发病和死亡的主要原因。不幸的是，肺炎链球菌对多种抗生素的耐药性日益增强。美国近期监测研究结果显示，对青霉素不敏感的肺炎链球菌患病率在25%至超过50%之间，据报道肺炎球菌对大环内酯类抗生素的耐药率高达31%。在耐青霉素菌株中发现对其他抗菌药物类别的高耐药率。在体外具有更好抗肺炎球菌活性的新型喹诺酮类药物（如加替沙星、吉米沙星和莫西沙星）是最有效的药物，因此是治疗成人社区获得性呼吸道感染的有吸引力的选择。应通过接种疫苗努力预防高危患者的肺炎球菌感染。
