Antibiotic Resistance and Community-Acquired Pneumonia during an Influenza Pandemic

2010 ◽  
pp. 51-69
Author(s):  
Matthew R. Moore ◽  
Cynthia G. Whitney
Keyword(s):  
Antibiotic Resistance ◽  
Influenza Pandemic ◽  
Community Acquired Pneumonia

Editorial

2008 ◽  
Vol 7 (1) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Emergency Medicine ◽  
Antibiotic Resistance ◽  
Respiratory Illness ◽  
Community Acquired Pneumonia ◽  
Antibiotic Prescribing ◽  
Acute Medicine ◽  
St Segment Elevation ◽  
Combined Training ◽  
Inappropriate Use ◽  
Exacerbation Of Copd

Infection control and antibiotic prescribing have been high on the list of priorities for clinicians working in acute medicine over recent years. Concerns about antibiotic resistance have encouraged many hospital-based and speciality society guidelines to take a broad spectrum approach to the septic patient. However, this approach risks exacerbating the problems of resistance and increasing the incidence of Clostridium Diffi cile diarrhoea, particularly amongst our elderly patients. Finding the appropriate balance is a key priority for physicians working at the hospital’s ‘front door’. Three of our review articles highlight some of the issues involved in this area. In an extensively researched review, Lille and Barlow provide a microbiological perspective on the topic of antibiotic resistance. Their approach suggests a mechanism for risk assessment in relation to the likelihood of antibiotic resistance, while the results of cultures are awaited. Although most hospitals have their own specifi c prescribing guidelines, the algorithms in this article should provide a useful reference guide. Two other reviews deal specifi cally with issues around management of acute respiratory illness. Distinction between community acquired pneumonia (CAP) and exacerbation of COPD remains a signifi cant area of confusion in relation to antibiotic prescribing. Inappropriate use of CAP severity scoring for patients with COPD frequently leads to over-use of intravenous antibiotics, for a condition which is often non-infective in origin. The medical complications of cocaine use are not as common a cause of hospital admission as pneumonia or COPD. However, the increasing recreational use of this drug, highlighted in the review by Irvine and Penston, requires that acute physicians are familiar with its consequences and their treatment. Cardiac-type chest pain and arrhythmias are the most likely complications to present on the acute medical take, but pneumothorax and pneumomediastinum are also well recognised. Consideration of cocaine as a cause for ST segment elevation is important, given that thrombolysis is generally contraindicated; pressure to administer thrombolytic drugs within 30 minutes for patients with STEMI requires that the appropriate questions are asked at the time of admission. Issues around acute medicine training and the interface with emergency medicine continue to cause controversy. In an article submitted in response to a Viewpoint article published last year, Gallitelli and colleagues imply that the approach in Italy is progressing towards the development of combined training in acute and emergency medicine. Although the development of Acute Care Common Stem rotations in the UK may suggest a step in a similar direction, there remains a need to fi nd ways in which specialist trainees in both areas can work more closely together to attain necessary competencies in management of acutely unwell adults.

Community-acquired pneumonia: aetiology, antibiotic resistance and prospects of phage therapy

2020 ◽  
Vol 32 (8) ◽  
pp. 395-410
Author(s):  
Md. Moinuddin Sheam ◽  
Shifath Bin Syed ◽  
Zulkar Nain ◽  
Swee- Seong Tang ◽  
Dipak Kumar Paul ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Phage Therapy ◽  
Community Acquired Pneumonia

scholarly journals Antibiotic Resistance Profiles of Haemophilus influenzae Isolates from Children in 2016: A Multicenter Study in China

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Hong-Jiao Wang ◽  
Chuan-Qing Wang ◽  
Chun-Zhen Hua ◽  
Hui Yu ◽  
Ting Zhang ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Haemophilus Influenzae ◽  
Disease Surveillance ◽  
Community Acquired Pneumonia ◽  
Clinical Treatment ◽  
Chinese Children ◽  
Infectious Disease Surveillance ◽  
First Choice ◽  
Vaginal Secretions ◽  
Resistance Rates

Background and Objective. Haemophilus influenzae (HI) is a common cause of community-acquired pneumonia in children. In many countries, HI strains are increasingly resistant to ampicillin and other commonly prescribed antibiotics, posing a challenge for effective clinical treatment. This study was undertaken to determine the antibiotic resistance profiles of HI isolates from Chinese children and to provide guidelines for clinical treatment. Methods. Our Infectious Disease Surveillance of Pediatrics (ISPED) collaboration group includes six children’s hospitals in different regions of China. The same protocols and guidelines were used by all collaborators for the culture and identification of HI. The Kirby–Bauer method was used to test antibiotic susceptibility, and a cefinase disc was used to detect β-lactamase activity. Results. We isolated 2073 HI strains in 2016: 83.9% from the respiratory tract, 11.1% from vaginal secretions, and 0.5% from blood. Patients with respiratory isolates were significantly younger than nonrespiratory patients (P<0.001). Of all 2073 strains, 50.3% were positive for β-lactamase and 58.1% were resistant to ampicillin; 9.3% were β-lactamase-negative and ampicillin-resistant. The resistance rates of the HI isolates to trimethoprim-sulfamethoxazole, azithromycin, cefuroxime, ampicillin-sulbactam, cefotaxime, and meropenem were 71.1%, 32.0%, 31.2%, 17.6%, 5.9%, and 0.2%, respectively. Conclusions. More than half of the HI strains isolated from Chinese children were resistant to ampicillin, primarily due to the production of β-lactamase. Cefotaxime and other third-generation cephalosporins could be the first choice for the treatment of ampicillin-resistant HI infections.

Antibiotic resistance of strains of Streptococcus pneumoniae isolated from hospitalized patients with community-acquired pneumonia in the republic of North Ossetia-Alania

2014 ◽  
Vol 20 (30) ◽  
pp. 105-108 ◽  
Author(s):  
Гатагонова ◽  
Tamara Gatagonova ◽  
Цаллагова ◽  
Olga Tsallagova ◽  
Болиева ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Streptococcus Pneumoniae ◽  
Antimicrobial Agents ◽  
Developed Countries ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
The Republic ◽  
Definition Of ◽  
Low Activity ◽  
North Ossetia

An increase of antibiotic resistance of bacteria, in particular, Streptococcus pneumoniae, has been registered recently in most developed countries. This necessitates the study of regional characteristics of etiological structure of causative bacterial agents of community-acquired pneumonia and their sensitivity to antibiotics. The aim of the study was to study the spectrum of bacterial pathogens of community-acquired pneumonia and the sensitivity of Streptococcus pneumoniae to antimicrobial agents in hospitalized patients in the Republic of North Ossetia - Alania. Bacteriological examination of sputum with definition of sensitivity of isolated strains of bacteria to antibiotics was performed in 270 patients with community-acquired pneumonia. According to our data, the main causative agent of community-acquired pneumonia in hospitalized patients in the Republic of North Ossetia-Alania is Streptococcus pneumoniae. III generation cephalosporins, respiratory fluoroquinolones, macrolides, showed high activity against Streptococcus pneumoniae isolated from hospitalized patients. Low activity of natural and semi-synthetic penicillins was shown. The obtained results allow optimizing of antimicrobial therapy of community-acquired pneumonia caused by Streptococcus pneumoniae.

scholarly journals Microbial landscape in hospital patients with new coronavirus disease (COVID-19), antibiotic resistance comparison vs. Pre-covid stage: a prospective study

2021 ◽  
Vol 28 (5) ◽  
pp. 14-28
Author(s):  
Marina G. Avdeeva ◽  
Makka I. Kulbuzheva ◽  
Sergey V. Zotov ◽  
Yelena V. Zhuravleva ◽  
Alina V. Yatsukova
Keyword(s):  
Antibiotic Resistance ◽  
Community Acquired Pneumonia ◽  
Patient Treatment ◽  
Hospital Treatment ◽  
Gram Positive ◽  
Gram Negative ◽  
Hospital Patients ◽  
Coronavirus Infection ◽  
Low Incidence ◽  
A Prospective Study

Background. The new coronavirus infection has manifested untypically compared to other acute respiratory agents, posing a major challenge to researchers worldwide. Despite low incidence of bacterial complications, microbial coinfection plays an important role in the onset and development of severe COVID-19 to hamper diagnosis, treatment and prognosis.Objectives. A study of microbial landscape in secondary complications of COVID-19 and prevailing microbial-agent antibiotic resistance dynamics in COVID-19 vs. patients with pre-COVID community-acquired pneumonia.Methods. We analysed 1,113 bacterial sputum cultures in COVID-19 patients from 21 hospital of Krasnodar Krai. The study sample comprised 524 strains isolated from COVID-19 patients in bacteriological assays. The comparison sample included 643 positive sputum strains isolated from community-acquired pneumonia patients developing disease in outcome of acute respiratory infection in 2015–2018. The microbial aetiology landscape and strain antibiotic resistance have been compared in COVID-19 vs. patients with community-acquired pneumonia.Results. Gram-negative bacteria predominated in COVID-19 cultures (58%), followed by Gram-positive bacteria (15%) and fungi (27%). Acinetobacter baumannii (35%) and Klebsiella pneumoniae (33%) were about equally represented in Gram-negative flora, Pseudomonas aeruginosa (19%) and other microorganisms were half as common. Streptococcus pneumonia and Staphylococcus aureus accounted for 48 and 15% Gram-positive strains, respectively. Sputum-isolated fungi were mainly identifi ed as Candida albicans (89%). The Streptoccocus pneumoniae detection rate dropped to 7% in 2020 relative of other flora, which is 10 times less vs. pre-COVID rates, whilst the fungal rate increased dramatically. Antibiotic resistance increased in most isolated microbial strains.Conclusion. A Gram-negative-dominated aetiology of lower respiratory tract lesions, as well as higher risk of fungal and other opportunistic coinfections should be taken into account in patient treatment for a complicated coronavirus infection. A higher antibiotic resistance is induced by active indication-ignorant use of antibiotics, including pre-hospital treatment. A suitable treatment regimen in COVID-19 should avoid undue antibiotic prescriptions in every patient.

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