JMI Laboratories, 345 Beaver Kreek Centre, Ste A, North Liberty, IA 52317, USA.
Int J Antimicrob Agents. 2010 Sep;36(3):197-204. doi: 10.1016/j.ijantimicag.2010.04.013. Epub 2010 Jun 16.
Pneumonia is a major infectious disease associated with significant morbidity, mortality and utilisation of healthcare resources. Streptococcus pneumoniae is the predominant pathogen in community-acquired pneumonia (CAP), accounting for 20-60% of bacterial cases. Emergence of multidrug-resistant S. pneumoniae has become a significant problem in the management of CAP. Although pneumococcal conjugate vaccine usage in children has led to significant decreases in morbidity and mortality due to S. pneumoniae in all age groups, disease management has been further complicated by the unexpected increase in resistant serotypes, such as 19A, in some regions. Until rapid and accurate diagnostic tests become available, initial treatment of CAP will remain empirical. Thus, selection of appropriate antimicrobial therapy for CAP must be based on prediction of the most likely pathogens and their local antimicrobial susceptibility patterns. This article reviews information on antimicrobial resistance patterns amongst S. pneumoniae and implications for managing CAP.
肺炎是一种主要的传染病，与发病率、死亡率和医疗资源的利用密切相关。肺炎链球菌是社区获得性肺炎（CAP）的主要病原体，占细菌病例的 20-60%。耐多药肺炎链球菌的出现已成为 CAP 管理中的一个重大问题。虽然儿童使用肺炎球菌结合疫苗已导致所有年龄段因肺炎链球菌导致的发病率和死亡率显著下降，但由于在某些地区出现了耐药血清型（如 19A）等意外情况，疾病管理变得更加复杂。在快速、准确的诊断测试问世之前，CAP 的初始治疗仍将是经验性的。因此，CAP 抗菌治疗的选择必须基于对最可能的病原体及其当地抗菌药物敏感性模式的预测。本文综述了肺炎链球菌的抗菌药物耐药模式及其对 CAP 管理的影响。
