Department of Medicine, AIDS Healthcare Foundation, 1300 N Vermont Avenue, Suite 407, Los Angeles, CA, 90027, USA,
Curr Infect Dis Rep. 2012 Jun;14(3):292-9. doi: 10.1007/s11908-012-0260-x.
Pneumonia is a major infectious disease associated with significant morbidity and mortality, with Streptococcus pneumoniae the predominant pathogen in community-acquired cases, accounting for 20% to 50% of bacterial cases. Although pneumococcal resistance to β-lactams is now common worldwide, high-dose parental penicillin G, many other parental β-lactams and some oral β-lactams continue to be efficacious. The new Clinical and Laboratory Standards Institute susceptibility breakpoints for parental penicillin G for nonmeningeal infections (≤2 μg/mL, susceptible; 4 μg/mL, intermediate; ≥8 μg/mL, resistant) introduced in 2008 facilitate appropriate reporting and use of penicillin G. Pneumococcal vaccine usage in children from 2000 has led to significant decreases in morbidity and mortality due to S. pneumoniae in all age groups, and the increase in resistant serotypes, such as 19A, appears to be decreasing following the introduction of an expanded valence vaccine in 2010. Judicious use of antimicrobial agents is the best long-term approach in order to reduce S. pneumoniae resistance.
肺炎是一种主要的传染病，与较高的发病率和死亡率相关，肺炎链球菌是社区获得性肺炎的主要病原体，占细菌病例的 20%至 50%。虽然肺炎球菌对β-内酰胺类药物的耐药性现在在全球范围内很常见，但高剂量青霉素 G、许多其他青霉素 G 类药物和一些口服β-内酰胺类药物仍然有效。2008 年引入的非脑膜感染的青霉素 G 新的临床和实验室标准协会药敏折点（≤2μg/ml，敏感；4μg/ml，中介；≥8μg/ml，耐药）有助于对青霉素 G 的适当报告和使用。自 2000 年以来，儿童使用肺炎球菌疫苗已导致所有年龄段因肺炎链球菌引起的发病率和死亡率显著下降，耐药血清型（如 19A）的增加似乎在 2010 年扩大价疫苗引入后有所减少。为了减少肺炎球菌的耐药性，明智地使用抗菌药物是最佳的长期方法。
